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Sample records for hypertension ages-reykjavik study

  1. Coronary artery calcium distributions in older persons in the AGES-Reykjavik study

    Gudmundsson, Elias Freyr; Gudnason, Vilmundur; Sigurdsson, Sigurdur; Launer, Lenore J.; Harris, Tamara B.; Aspelund, Thor

    2013-01-01

    Coronary Artery Calcium (CAC) is a sign of advanced atherosclerosis and an independent risk factor for cardiac events. Here, we describe CAC-distributions in an unselected aged population and compare modelling methods to characterize CAC-distribution. CAC is difficult to model because it has a skewed and zero inflated distribution with over-dispersion. Data are from the AGES-Reykjavik sample, a large population based study [2002-2006] in Iceland of 5,764 persons aged 66-96 years. Linear regressions using logarithmic- and Box-Cox transformations on CAC+1, quantile regression and a Zero-Inflated Negative Binomial model (ZINB) were applied. Methods were compared visually and with the PRESS-statistic, R2 and number of detected associations with concurrently measured variables. There were pronounced differences in CAC according to sex, age, history of coronary events and presence of plaque in the carotid artery. Associations with conventional coronary artery disease (CAD) risk factors varied between the sexes. The ZINB model provided the best results with respect to the PRESS-statistic, R2, and predicted proportion of zero scores. The ZINB model detected similar numbers of associations as the linear regression on ln(CAC+1) and usually with the same risk factors. PMID:22990371

  2. N-terminal pro-brain natriuretic peptide and abnormal brain aging: The AGES-Reykjavik Study.

    Sabayan, Behnam; van Buchem, Mark A; de Craen, Anton J M; Sigurdsson, Sigurdur; Zhang, Qian; Harris, Tamara B; Gudnason, Vilmundur; Arai, Andrew E; Launer, Lenore J

    2015-09-01

    To investigate the independent association of serum N-terminal fragment of the prohormone natriuretic peptide (NT-proBNP) with structural and functional features of abnormal brain aging in older individuals. In this cross-sectional study based on the Age, Gene/Environment Susceptibility (AGES)-Reykjavik Study, we included 4,029 older community-dwelling individuals (born 1907 to 1935) with a measured serum level of NT-proBNP. Outcomes included parenchymal brain volumes estimated from brain MRI, cognitive function measured by tests of memory, processing speed, and executive functioning, and presence of depressive symptoms measured using the Geriatric Depression Scale. In a substudy, cardiac output of 857 participants was assessed using cardiac MRI. In multivariate analyses, adjusted for sociodemographic and cardiovascular factors, higher levels of NT-proBNP were independently associated with lower total (p brain volumes. Likewise, in multivariate analyses, higher levels of NT-proBNP were associated with worse scores in memory (p = 0.005), processing speed (p = 0.001), executive functioning (p brain parenchymal volumes, impaired executive function and processing speed, and higher depressive symptoms were independent of the level of cardiac output. Higher serum levels of NT-proBNP, independent of cardiovascular risk factors and a measure of cardiac function, are linked with alterations in brain structure and function. Roles of natriuretic peptides in the process of brain aging need to be further elucidated. © 2015 American Academy of Neurology.

  3. Proximal Femur Volumetric Bone Mineral Density and Mortality: 13 Years of Follow-Up of the AGES-Reykjavik Study.

    Marques, Elisa A; Elbejjani, Martine; Gudnason, Vilmundur; Sigurdsson, Gunnar; Lang, Thomas; Sigurdsson, Sigurdur; Aspelund, Thor; Meirelles, Osorio; Siggeirsdottir, Kristin; Launer, Lenore; Eiriksdottir, Gudny; Harris, Tamara B

    2017-06-01

    Bone mineral density (BMD) has been linked to mortality, but little is known about the independent contribution of each endosteal bone compartment and also the rate of bone loss to risk of mortality. We examined the relationships between (1) baseline trabecular and cortical volumetric BMD (vBMD) at the proximal femur, and (2) the rate of trabecular and cortical bone loss and all-cause mortality in older adults from the AGES-Reykjavik study. The analysis of trabecular and cortical vBMD and mortality was based on the baseline cohort of 4654 participants (aged ≥66 years) with a median follow-up of 9.4 years; the association between rate of bone loss and mortality was based on 2653 participants with bone loss data (median follow-up of 5.6 years). Analyses employed multivariable Cox-proportional models to estimate hazard ratios (HRs) with time-varying fracture status; trabecular and cortical variables were included together in all models. Adjusted for important confounders, Cox models showed that participants in the lowest quartile of trabecular vBMD had an increased risk of mortality compared to participants in other quartiles (HR = 1.12; 95% confidence interval (CI), 1.01 to 1.25); baseline cortical vBMD was not related to mortality (HR = 1.08; 95% CI, 0.97 to 1.20). After adjustment for time-dependent fracture status, results were attenuated and not statistically significant. A faster loss (quartile 1 versus quartiles 2-4) in both trabecular and cortical bone was associated with higher mortality risk (HR = 1.37 and 1.33, respectively); these associations were independent of major potential confounders including time-dependent incident fractures (HR = 1.32 and 1.34, respectively). Overall, data suggest that faster bone losses over time in both the trabecular and cortical bone compartments are associated with mortality risk and that measurements of change in bone health may be more informative than single-point measurements in explaining mortality

  4. Mid-thigh cortical bone structural parameters, muscle mass and strength, and association with lower limb fractures in older men and women (AGES-Reykjavik Study).

    Johannesdottir, Fjola; Aspelund, Thor; Siggeirsdottir, Kristin; Jonsson, Brynjolfur Y; Mogensen, Brynjolfur; Sigurdsson, Sigurdur; Harris, Tamara B; Gudnason, Vilmundur G; Lang, Thomas F; Sigurdsson, Gunnar

    2012-05-01

    In a cross-sectional study we investigated the relationship between muscle and bone parameters in the mid-thigh in older people using data from a single axial computed tomographic section through the mid-thigh. Additionally, we studied the association of these variables with incident low-trauma lower limb fractures. A total of 3,762 older individuals (1,838 men and 1,924 women), aged 66-96 years, participants in the AGES-Reykjavik study, were studied. The total cross-sectional muscular area and knee extensor strength declined with age similarly in both sexes. Muscle parameters correlated most strongly with cortical area and total shaft area (adjusted for age, height, and weight) but explained lower limb fractures. Small muscular area, low knee extensor strength, large MA, low cortical thickness, and high BR were significantly associated with fractures in both sexes. Our results show that bone and muscle loss proceed at different rates and with different gender patterns.

  5. Are bone turnover markers associated with volumetric bone density, size, and strength in older men and women? The AGES-Reykjavik study.

    Marques, E A; Gudnason, V; Sigurdsson, G; Lang, T; Johannesdottir, F; Siggeirsdottir, K; Launer, L; Eiriksdottir, G; Harris, T B

    2016-05-01

    Association between serum bone formation and resorption markers and bone mineral, structural, and strength variables derived from quantitative computed tomography (QCT) in a population-based cohort of 1745 older adults was assessed. The association was weak for lumbar spine and femoral neck areal and volumetric bone mineral density. The aim of this study was to examine the relationship between levels of bone turnover markers (BTMs; osteocalcin (OC), C-terminal cross-linking telopeptide of type I collagen (CTX), and procollagen type 1N propeptide (P1NP)) and quantitative computed tomography (QCT)-derived bone density, geometry, and strength indices in the lumbar spine and femoral neck (FN). A total of 1745 older individuals (773 men and 972 women, aged 66-92 years) from the Age, Gene/Environment Susceptibility (AGES)-Reykjavik cohort were studied. QCT was performed in the lumbar spine and hip to estimate volumetric trabecular, cortical, and integral bone mineral density (BMD), areal BMD, bone geometry, and bone strength indices. Association between BTMs and QCT variables were explored using multivariable linear regression. Major findings showed that all BMD measures, FN cortical index, and compressive strength had a low negative correlation with the BTM levels in both men and women. Correlations between BTMs and bone size parameters were minimal or not significant. No associations were found between BTMs and vertebral cross-sectional area in women. BTMs alone accounted for only a relatively small percentage of the bone parameter variance (1-10 %). Serum CTX, OC, and P1NP were weakly correlated with lumbar spine and FN areal and volumetric BMD and strength measures. Most of the bone size indices were not associated with BTMs; thus, the selected bone remodeling markers do not reflect periosteal bone formation. These results confirmed the limited ability of the most sensitive established BTMs to predict bone structural integrity in older adults.

  6. Incidence of Brain Infarcts, Cognitive Change, and Risk of Dementia in the General Population: The AGES-Reykjavik Study (Age Gene/Environment Susceptibility-Reykjavik Study).

    Sigurdsson, Sigurdur; Aspelund, Thor; Kjartansson, Olafur; Gudmundsson, Elias F; Jonsdottir, Maria K; Eiriksdottir, Gudny; Jonsson, Palmi V; van Buchem, Mark A; Gudnason, Vilmundur; Launer, Lenore J

    2017-09-01

    The differentiation of brain infarcts by region is important because their cause and clinical implications may differ. Information on the incidence of these lesions and association with cognition and dementia from longitudinal population studies is scarce. We investigated the incidence of infarcts in cortical, subcortical, cerebellar, and overall brain regions and how prevalent and incident infarcts associate with cognitive change and incident dementia. Participants (n=2612, 41% men, mean age 74.6±4.8) underwent brain magnetic resonance imaging for the assessment of infarcts and cognitive testing at baseline and on average 5.2 years later. Incident dementia was assessed according to the international guidelines. Twenty-one percent of the study participants developed new infarcts. The risk of incident infarcts in men was higher than the risk in women (1.8; 95% confidence interval, 1.5-2.3). Persons with both incident and prevalent infarcts showed steeper cognitive decline and had almost double relative risk of incident dementia (1.7; 95% confidence interval, 1.3-2.2) compared with those without infarcts. Persons with new subcortical infarcts had the highest risk of incident dementia compared with those without infarcts (2.6; 95% confidence interval, 1.9-3.4). Men are at greater risk of developing incident brain infarcts than women. Persons with incident brain infarcts decline faster in cognition and have an increased risk of dementia compared with those free of infarcts. Incident subcortical infarcts contribute more than cortical and cerebellar infarcts to incident dementia which may indicate that infarcts of small vessel disease origin contribute more to the development of dementia than infarcts of embolic origin in larger vessels. © 2017 American Heart Association, Inc.

  7. hypertension

    Emine Hatipoglu

    2013-05-01

    Full Text Available Hypertension is a common disease associated with important cardiovascular complications. Persistent blood pressure of 140/90 or higher despite combined use of a reninangiotensin system blocker, calcium channel blocker and a diuretic at highest tolerated doses constitutes resistant hypertension. Excess sympathetic activity plays an important pathogenic role in resistant hypertension in addition to contributing to the development of metabolic problems, in particular diabetes. Reduction of renal sympathetic activity by percutaneous catheter-based radiofrequency ablation via the renal arteries has been shown in several studies to decrease blood pressure in patients with resistant hypertension, and importantly is largely free of significant complications. However, longer term follow-up is required to confirm both long-term safety and efficacy.

  8. Hypertension

    ... role in the start and continuation of primary hypertension. Secondary hypertension is due to other diseases such as kidney ... the body can greatly improve or even cure secondary hypertension. Obstructive sleep apnea is a potentially serious sleep ...

  9. Masked Hypertension and Incident Clinic Hypertension among African Americans in the Jackson Heart Study

    Abdalla, Marwah; Booth, John N.; Seals, Samantha R.; Spruill, Tanya M.; Viera, Anthony J.; Diaz, Keith M.; Sims, Mario; Muntner, Paul; Shimbo, Daichi

    2016-01-01

    Masked hypertension, defined as non-elevated clinic blood pressure and elevated out-of-clinic blood pressure may be an intermediary stage in the progression from normotension to hypertension. We examined the associations of out-of-clinic blood pressure and masked hypertension using ambulatory blood pressure monitoring with incident clinic hypertension in the Jackson Heart Study, a prospective cohort of African Americans. Analyses included 317 participants with clinic blood pressure hypertension was defined as mean daytime blood pressure ≥135/85mmHg; masked nighttime hypertension as mean nighttime blood pressure ≥120/70mmHg; and masked 24-hour hypertension as mean 24-hour blood pressure ≥130/80mmHg. Incident clinic hypertension, assessed at study visits in 2005–2008 and 2009–2012, was defined as the first visit with clinic systolic/diastolic blood pressure ≥140/90mmHg or antihypertensive medication use. During a median follow-up of 8.1 years, there were 187 (59.0%) incident cases of clinic hypertension. Clinic hypertension developed in 79.2% and 42.2% of participants with and without any masked hypertension, 85.7% and 50.4% with and without masked daytime hypertension, 79.9% and 43.7% with and without masked nighttime hypertension and 85.7% and 48.2% with and without masked 24-hour hypertension, respectively. Multivariable-adjusted hazard ratios (95% CI) of incident clinic hypertension for any masked hypertension and masked daytime, nighttime, and 24-hour hypertension were 2.13 (1.51–3.02), 1.79 (1.24–2.60), 2.22 (1.58–3.12), and 1.91 (1.32–2.75), respectively. These findings suggest that ambulatory blood pressure monitoring can identify African Americans at increased risk for developing clinic hypertension. PMID:27185746

  10. Pulmonary hypertension in patients with hepatic cirrhosis and portal hypertension. An echographic study.

    Gurghean, Adriana V; Tudor, Ioana A

    2017-01-01

    The aim of the study is to determine the frequency of pulmonary hypertension in patients with hepatic cirrhosis and portal hypertension, to determine the possibility of an accurate ultrasound diagnosis of the characteristics of this complication. 347 patients with liver cirrhosis consecutively hospitalized at Coltea Clinical Hospital were screened. 61 were excluded because of other possible causes of portal or pulmonary hypertension. All patients were investigated clinically and by abdominal and cardiac ultrasonography. Of the remaining 286 patients, 116 had portal hypertension, 27 of them (23%) having pulmonary hypertension. In this group we found a higher cardiac index and right atrial volume, higher pressures in the right atrium, suggesting a hyperdynamic state. Porto-pulmonary hypertension was found in only one patient. Echocardiography permits characterization of patients with cirrhosis and portal hypertension.

  11. Clinical features of paediatric pulmonary hypertension : a registry study

    Berger, Rolf M. F.; Beghetti, Maurice; Humpl, Tilman; Raskob, Gary E.; Ivy, D. Dunbar; Jing, Zhi-Cheng; Bonnet, Damien; Schulze-Neick, Ingram; Barst, Robyn J.

    2012-01-01

    Background Paediatric pulmonary hypertension, is an important cause of morbidity and mortality, and is insufficiently characterised in children. The Tracking Outcomes and Practice in Pediatric Pulmonary Hypertension (TOPP) registry is a global, prospective study designed to provide information about

  12. An epidemiological study of paediatric pulmonary hypertension in Turkey.

    Pektas, Ayhan; Pektas, Bilgehan M; Kula, Serdar

    2016-04-01

    The present study aims to evaluate the epidemiological characteristics of paediatric pulmonary hypertension within the entire Turkish population over a period of 5 years using the registry of the National Health Insurance System. All individuals aged pulmonary hypertension and secondary pulmonary hypertension were identified. The overall annual incidence of idiopathic pulmonary hypertension during childhood was 11.7 cases/million, whereas the overall annual incidence of secondary pulmonary hypertension during childhood was 9.5 cases/million. There was a gradual and significant increase in the annual incidence of idiopathic pulmonary hypertension and that of secondary pulmonary hypertension during the 5-year study period (p=0.001 for both). In the years 2012 and 2013, idiopathic pulmonary hypertension was significantly more frequent in children aged pulmonary hypertension, whereas the female to male ratio was 1.1:1 for secondary pulmonary hypertension during childhood. The incidence of paediatric pulmonary hypertension in Turkey is higher than those reported for the Western populations. Moreover, no female dominance could be observed. These discrepancies may be attributed to the differences in the study design, study cohort, timing of the study, and the definitions adopted for pulmonary hypertension classification.

  13. Perivesical varices and portal hypertension: imaging study

    Mallorquin Jimenez, F.; Medina Benitez, A.; Lopez Machado, E.; Pardo Moreno, M.D.; Garrido Moreno, C.; Pastor Rull, J.

    1995-01-01

    Nine patients with portal hypertension syndrome and Perivesical varices are studied retrospectively by means of imaging techniques including ultrasound, duplex Doppler, color Doppler, CT and angiography. All the patients presented portal thrombosis and thickening of the bladder wall. These collaterals either represent a shunting of hepato pedal flow or correspond to blood stasis associated with said syndrome. Ultrasound, whether involving duplex Doppler or color Doppler techniques, is highly useful to detect the presence of Perivesical varices which appear as tubular or rounded hypo echogenic areas in the bladder wall. Given the association of this entity with bladder wall thickening, it should be taken into account in any clinical situation involving said change, especially in patients with portal hypertension; moreover knowledge of its presence is of great importance when the possibility of creating shunts by means of interventional or surgical vascular procedures or other types of abdominal procedures are being considered because of the risk of bleeding. (Author)

  14. Relationship Between Epistaxis And Hypertension: A Study Of ...

    Both epistaxis and hypertension are common in the general population. This study aimed at determining the prevalence of hypertension among epistaxics, and the relationship between epistaxis and hypertension. Retrospective analysis of 62 adults comprising 31 each of males and females with a mean age of 41.4 ± 16.6 ...

  15. Hypertension

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — These datasets provide de-identified insurance data for hypertension hyperlipidemia. The data is provided by three managed care organizations in Allegheny County...

  16. Hypertension

    Farrugia, Emanuel

    2004-01-01

    Hypertension is a rapidly moving clinical field with frequent developments in new pharmacologic agents and management strategies. Perhaps more importantly, there have been substantial improvements in our understanding of how best to use the drugs available to us. In this article, I will review some of the more important advances in our understanding of hypertension over the past two years, specifically by reviewing six important trials, one survey and two sets of guidelines, all published bet...

  17. Lifestyle in progression from hypertensive disorders of pregnancy to chronic hypertension in Nurses' Health Study II: observational cohort study.

    Timpka, Simon; Stuart, Jennifer J; Tanz, Lauren J; Rimm, Eric B; Franks, Paul W; Rich-Edwards, Janet W

    2017-07-12

    Objectives  To study the association between lifestyle risk factors and chronic hypertension by history of hypertensive disorders of pregnancy (HDP: gestational hypertension and pre-eclampsia) and investigate the extent to which these risk factors modify the association between HDP and chronic hypertension. Design  Prospective cohort study. Setting  Nurses' Health Study II (1991-2013). Participants  54 588 parous women aged 32 to 59 years with data on reproductive history and without previous chronic hypertension, stroke, or myocardial infarction. Main outcome measure  Chronic hypertension diagnosed by a physician and indicated through nurse participant self report. Multivariable Cox proportional hazards models were used to investigate the development of chronic hypertension contingent on history of HDP and four lifestyle risk factors: post-pregnancy body mass index, physical activity, adherence to the Dietary Approaches to Stop Hypertension (DASH) diet, and dietary sodium/potassium intake. Potential effect modification (interaction) between each lifestyle factor and previous HDP was evaluated with the relative excess risk due to interaction. Results  10% (n=5520) of women had a history of HDP at baseline. 13 971 cases of chronic hypertension occurred during 689 988 person years of follow-up. Being overweight or obese was the only lifestyle factor consistently associated with higher risk of chronic hypertension. Higher body mass index, in particular, also increased the risk of chronic hypertension associated with history of HDP (relative excess risk due to interaction Psodium/potassium intake on the association between HDP and chronic hypertension. Conclusion  This study suggests that the risk of chronic hypertension after HDP might be markedly reduced by adherence to a beneficial lifestyle. Compared with women without a history of HDP, keeping a healthy weight seems to be especially important with such a history.

  18. Hypertension in pregnancy: A community-based study

    Bharti Mehta

    2015-01-01

    Full Text Available Background: Hypertensive disorders during pregnancy occur in women with preexisting primary or secondary chronic hypertension, and in women who develop new-onset hypertension in the second half of pregnancy. The present study was undertaken to study the prevalence and correlates of hypertension in pregnancy in a rural block of Haryana. Materials and Methods: This cross-sectional study was carried out in the all 20 subcenters under Community Health Center (CHC Chiri, Block Lakhanmajra. All the pregnant women registered at the particular subcenter at a point of time of visit were included in the study. Appropriate statistical tests were used for analysis. Results: A total of 931 pregnant women were included in the present study. Prevalence of hypertension in pregnancy was found to be 6.9%. Maternal age ΃25 years, gestational period ͳ20 weeks, history of cesarean section, history of preterm delivery, and history of hypertension in previous pregnancy were found to be significantly associated with prevalence of hypertension in pregnancy. Conclusion: Nearly one in 14 pregnant women in rural areas of Haryana suffers from a hypertensive disorder of pregnancy. Early diagnosis and treatment through regular antenatal checkup is a key factor to prevent hypertensive disorders of pregnancy and its complications.

  19. Pulmonary hypertension in patients with Martorell hypertensive leg ulcer: a case control study

    2012-01-01

    Background Martorell hypertensive ischemic leg ulcer (Martorell ulcer) is characterized by distinct alterations in the arteriolar wall of subcutaneous vessels, leading to progressive narrowing of the vascular lumen and increase of vascular resistance. These changes are similar to the alterations observed in pulmonary arterioles in patients with chronic pulmonary hypertension (PH). This study was aimed to assess an association between the two disorders. Methods In this case–control study, 14 patients with Martorell ulcer were clinically assessed for the presence of pulmonary hypertension using transthoracic Doppler echocardiography. Data from patients were compared to 28 matched hypertensive controls. Results Systolic pulmonary arterial pressure (sPAP) in patients with Martorell ulcer was significantly higher than in the control group (33.8 ± 16.9 vs 25.3 ± 6.5 mmHg, p = 0.023); the prevalence of pulmonary hypertension was 31% (5/14) in patients and 7% (2/28) in controls (p = 0.031). No differences were seen in left heart size and function between patients and controls. Conclusion This study provides first evidence that subcutaneous arteriolosclerosis, the hallmark of Martorell ulcer, is associated with PH. These findings suggest that patients with Martorell leg ulcer might be at significant risk to develop elevated pulmonary arterial pressure. Patients with leg ulcers who present with dyspnea should be evaluated by echocardiography for the presence of pulmonary hypertension. PMID:22686459

  20. The evaluation of arterial stiffness of essential hypertension and white coat hypertension in children: a case-control study.

    Tokgöz, Semiha Terlemez; Yılmaz, Dilek; Tokgöz, Yavuz; Çelik, Bülent; Bulut, Yasin

    2018-03-01

    The aim of this study was to determine and compare cardiovascular risks by assessing arterial stiffness in children with essential hypertension and white coat hypertension. Paediatric patients followed up with essential hypertension and white coat hypertension diagnoses and with no established end organ damage were involved in the study. Arterial stiffness in children included in the study was evaluated and compared by using the oscillometric device (Mobil-O-Graph) method. A total of 62 essential hypertension (34 male, 28 female), 38 white coat hypertension (21 male, 17 female), and 60 healthy controls (33 male, 27 female) were assessed in the present study. Pulse wave velocity of the essential hypertension, white coat hypertension, and control group was, respectively, as follows: 5.3±0.6 (m/s), 5.1±0.4 (m/s), 4.3±0.4 (m/s) (pcoat hypertension were found to be higher compared with the control group. This level was identified as correlated with the duration of hypertension in both patient groups (pcoat hypertension was impaired compared with healthy children. This finding has made us think that white coat hypertension is not an innocent clinical situation. This information should be taken into consideration in the follow-up and treatment approaches of the patients.

  1. Cervical spondylosis and hypertension: a clinical study of 2 cases.

    Peng, Baogan; Pang, Xiaodong; Li, Duanming; Yang, Hong

    2015-03-01

    Cervical spondylosis and hypertension are all common diseases, but the relationship between them has never been studied. Patients with cervical spondylosis are often accompanied with vertigo. Anterior cervical discectomy and fusion is an effective method of treatment for cervical spondylosis with cervical vertigo that is unresponsive to conservative therapy. We report 2 patients of cervical spondylosis with concomitant cervical vertigo and hypertension who were treated successfully with anterior cervical discectomy and fusion. Stimulation of sympathetic nerve fibers in pathologically degenerative disc could produce sympathetic excitation, and induce a sympathetic reflex to cause cervical vertigo and hypertension. In addition, chronic neck pain could contribute to hypertension development through sympathetic arousal and failure of normal homeostatic pain regulatory mechanisms. Cervical spondylosis may be one of the causes of secondary hypertension. Early treatment for resolution of symptoms of cervical spondylosis may have a beneficial impact on cardiovascular disease risk in patients with cervical spondylosis.

  2. A study on hypertensive intracerebral hemorrhage

    Miura, Naohisa

    1982-01-01

    We studied 235 patients with hypertensive intracerebral hemorrhage by CT for about five years. An acute intracerebral hematoma is characterized by sharply delineated high density area. Repeated CT examinations demonstrate reduction in size of the high density hematoma after intervals of 20 - 40 days. And then, in general, the areas formerly occupied with hematoma show normal or reduced density. One or two days after hemorrhage, the high density is surrounded by a thin low density zone. After a few days the low density area is seen at the anterior and posterior pole of the high density in the white matter. These low density are produced by edema or resolving hematoma. About five days after hemorrhage, high density area is associated with wide surrounding low density zone of edema and then gradually diminishes in size. The wide low density zone surrounding the high density of hematoma persisting for over 15 days is probably composed not only of edema, but also of liquefied hematoma, necrotic brain tissue and so on. Enlarged hematoma and surrounding low density area extend to anterior, posterior, superior and inferior direction in the white matter. CT studies with i.v. contrast enhancement demonstrate from the 2nd to 4th weeks a ring-shaped high density around the hematoma. We classified each of the putaminal and thalamic hemorrhage into four types based on CT findings of hematoma advancement. In this study, a statistical method of Speareman's coefficients of rank correlation was utilized. According to this investigation, the important factors influencing prognosis and operative results were found to be the CT findings including the location and size of a hematoma, as well as the rapidity and the direction of its evolution. (J.P.N.)

  3. Clinical analysis of hypertension in children: An urban Indian study

    Sunil K Kota

    2013-01-01

    Full Text Available Hypertension in children, although an uncommon entity, is associated with end-organ damage. We tried to study the clinical profile of hypertension in children presented to our hospital. The medical records from January 1990 to December 2010 of all children aged 18 years and younger with hypertension were studied. The patients were divided into four age groups (infants, pre-school age, school age and adolescents Presenting symptoms and other clinical parameters were thoroughly evaluated. The results were compared with previous studies on hypertension in children. A total of 135 patients were selected (male:female 103:32, with mean age of 0.4 ± 2.1 years (range: six months to 17 years. The most common age group affected was the adolescents group (42.9%. The most common clinical feature at presentation was dizziness (30.3%, followed by headache and chest discomfort (22.9%. Transient hypertension was detected in 34 patients (25.2%, and was most common in the adolescent age group, whereas sustained hypertension was noticed in 101 patients (74.8% and was the most common in the school age group (36/45, 80%. Forty-two patients (31.1% presented with hypertensive crisis. Nine patients were considered to have essential hypertension. The chief causes included chronic glomerulonephritis in 56 (41.5%, endocrine disorders in 21 (15.5%, obstructive uropathy in 16 (11.8%, reflux nephropathy in 12 (8.8% and renovascular disease in 5 (3.7%. Takayasu′s disease was the most common cause of renovascular hypertension. Coarctation of aorta was the most common cause of hypertension in infancy, being present in 40% of the cases. Hypertension in children may be easily underestimated but is a potentially life-threatening problem. Most of them are asymptomatic and a large chunk has an underlying etiology. Primary care clinicians should promptly identify patients with hypertension and treat them immediately and appropriately to prevent damage to the cardiovascular organs.

  4. Assessment of Knowledge on Hypertension among Hypertensive Patients in Bandung City: A Preliminary Study

    Rano K. Sinuraya

    2017-12-01

    Full Text Available Hypertension is a common health problems that can increase the mortality and mobility rate in the community. As a silent killer, the prevalence of this disease is increasing worldwide. The prevalence of hypertension in Indonesia is 25.8% and West Java is ranked at top four with prevalence of 29.4%. This study aimed to measure the level of knowledge of hypertensive patients about their disease. This study was an observational study using cross-sectional design in June–October 2017 at Apotek Pendidikan Universitas Padjadjaran, Bandung City. A total of one hundred and fifty respondents completed a validated questionnaire after signing informed consent. The results showed that 56.7% of respondents have “good” level of knowledge, 40% of respondents have “moderate” level of knowledge, and 3.3% of respondents have “poor” level of knowledge. Data were analyzed statistically, the results showed that there was no significant difference (p>0.05 between each group of respondents to sociodemographic and clinical characteristics of the patients. Only fifty percent of respondents have “good” level of knowledge, patients who have “moderate” and “poor” level of knowledge generally are patients with low levels of education and suffer from hypertension less than five years.

  5. Cardiorespiratory fitness, BMI, and risk of hypertension: the HYPGENE study.

    Rankinen, Tuomo; Church, Timothy S; Rice, Treva; Bouchard, Claude; Blair, Steven N

    2007-10-01

    Cardiorespiratory fitness and regular physical activity are inversely associated with the risk of hypertension, and exercise training has been shown to lower elevated blood pressure (BP). Genetic factors contribute significantly to the interindividual differences in endurance training-induced changes in BP. However, similar data on the genotype-by-fitness interactions on the risk of hypertension are scarce. In 2000, we started a systematic collection of blood samples from all consenting subjects of the Aerobics Center Longitudinal Study (ACLS) with a goal to generate a resource for studies addressing genotype-by-fitness interaction effects on various health-related end points. Here, we introduce the rationale and design of the first study based on the ACLS genetics resource focusing on hypertension as the health outcome (HYPGENE study), and we report the associations of cardiorespiratory fitness and body mass index (BMI) with the risk of hypertension. All HYPGENE subjects (N = 1234) were healthy and normotensive at their first clinic visit. Cases (N = 629) developed hypertension during the follow-up period (mean 8.7 yr), whereas controls (N = 605) remained normotensive (mean follow-up 10.1 yr). Cardiorespiratory fitness was the strongest predictor of the hypertension risk, with each maximal metabolic equivalent unit being associated with a 19% lower risk (95% confidence interval [95% CI], 12-24%). Each baseline BMI unit was associated with a 9% higher hypertension risk (95% CI, 4-13%). However, the association of BMI was greatly attenuated (odds ratio 1.04 [95% CI, 0.99-1.09]) when fitness also was included in the model. The HYPGENE study will provide an excellent resource to address hypotheses regarding the genetic basis of hypertension while taking cardiorespiratory fitness level into account.

  6. Arterial scleroproteins in atherosclerosis and hypertension (Experimental studies)

    Yurukova, Ts.; Georgiev, P.

    1979-01-01

    The authors studied the neosynthesis of fiber protein (scleroproteins) in the aorta of rats with genetic hypertension and with experimental atherosclerosis following application of 3 H-proline and 3 H-lysine and subsequent determination of radioactivity of the collagen and elastic fractions of the aortic wall. There was a great increase in incorporation of labelled collagen and elastin precursors in the aorta of hypertensive and atherosclerotic animals, in comparison with the control rats - a manifestation of incresed ''de novo'' synthesis of fiber proteins in rats with these arterial diseases. Furthermore, the increased collagenosis dominated over that of elastogenesis. The irregular activation of the biosynthesis of both scleroproteins in hypertensive rats and in rats with atherosclerosis caused remodelling of the macromolecular structure of the arterial wall with predominance of collagen over the remaining hypertension components and progression of atherosclerosis. (author) (author)

  7. Large meta-analysis of genome-wide association studies identifies five loci for lean body mass

    Zillikens, Carola M.; Demissie, Serkalem; Hsu, Yi-Hsiang; Yerges-Armstrong, Laura M.; Chou, Wen-Chi; Stolk, Lisette; Demuth, Ilja; Steinhagen-Thiessen, Elisabeth [u.v.m.

    2017-01-01

    We acknowledge the essential role of the Cohorts for Heart and Aging Research in Genome Epidemiology (CHARGE) Consortium in development and support of this manuscript. CHARGE members include the Netherland’s Rotterdam Study (RS), Framingham Heart Study (FHS), Cardiovascular Health Study (CHS), the NHLBI’s Atherosclerosis Risk in Communities (ARIC) Study, and Iceland’s Age, Gene/Environment Susceptibility (AGES) Reykjavik Study. Age, Gene/Environment Susceptibility Reykjavik Study (AGES-Reykja...

  8. Studies on arterial stiffness and wave reflections in hypertension.

    Safar, Michel E; Levy, Bernard I

    2015-01-01

    Patho-physiological and pharmacological studies have consistently noticed that, with the exception of subjects with end-stage renal disease, total intravascular blood volume is not increased in patients with chronic hypertension. Because the mean circulatory pressure is enhanced in such subjects, it was postulated that the compliance of the cardiovascular system could be abnormally low in this particular population. This simple observation has influenced a great part of our experimental and clinical research directed toward subjects with hypertension and their relationship with the compliance of the vascular system. These works started between 1970 and 1980 by methodological investigations and validations followed by analysis of clinical situations that showed that venous and mostly arterial stiffness were significantly increased in hypertensive patients independently of blood pressure level. During the same time, we assessed the role of endothelium on the large arterial wall mechanical properties in normotensive and hypertensive rats. Thereafter more specific directions have been developed, affecting large arteries structure and function and arterial wall remodeling, including their consequences on central and peripheral hemodynamics. In parallel, epidemiological studies identified the pulsatile hemodynamic parameters as major independent predictors of cardiovascular risks. The consequences of these alterations on clinical pharmacology and therapeutics in hypertension are analyzed in detail. © American Journal of Hypertension, Ltd 2014. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  9. Risk of post-pregnancy hypertension in women with a history of hypertensive disorders of pregnancy: nationwide cohort study.

    Behrens, Ida; Basit, Saima; Melbye, Mads; Lykke, Jacob A; Wohlfahrt, Jan; Bundgaard, Henning; Thilaganathan, Baskaran; Boyd, Heather A

    2017-07-12

    Objectives  To determine how soon after delivery the risk of post-pregnancy hypertension increases in women with hypertensive disorders of pregnancy and how the risk evolves over time. Design  Nationwide register based cohort study. Setting  Denmark. Populations  482 972 primiparous women with a first live birth or stillbirth between 1995 and 2012 (cumulative incidence analyses), and 1 025 118 women with at least one live birth or stillbirth between 1978 and 2012 (Cox regression analyses). Main outcome measures  10 year cumulative incidences of post-pregnancy hypertension requiring treatment with prescription drugs, and hazard ratios estimated using Cox regression. Results  Of women with a hypertensive disorder of pregnancy in a first pregnancy in their 20s, 14% developed hypertension in the first decade post partum, compared with 4% of women with normotensive first pregnancies in their 20s. The corresponding percentages for women with a first pregnancy in their 40s were 32% and 11%, respectively. In the year after delivery, women with a hypertensive disorder of pregnancy had 12-fold to 25-fold higher rates of hypertension than did women with a normotensive pregnancy. Rates in women with a hypertensive disorder of pregnancy were threefold to 10-fold higher 1-10 years post partum and remained twice as high even 20 or more years later. Conclusions  The risk of hypertension associated with hypertensive disorders of pregnancy is high immediately after an affected pregnancy and persists for more than 20 years. Up to one third of women with a hypertensive disorder of pregnancy may develop hypertension within a decade of an affected pregnancy, indicating that cardiovascular disease prevention in these women should include blood pressure monitoring initiated soon after pregnancy. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  10. Magnesium supplement in pregnancy-induced hypertension. A clinicopathological study

    Rudnicki, M; Junge, Jette; Frølich, A

    1990-01-01

    The placenta and the umbilical cord obtained from 18 women with pregnancy-induced hypertension were investigated by light microscopy. The umbilical artery was studied by electron microscopy. 10 placentae and umbilical cords from normal pregnancies served as controls. The study was performed...... fibrosis or intervillous fibrin. Ultrastructurally, the endothelial cells of the umbilical arteries from women with pregnancy-induced hypertension showed a significant increase in the amount of dilated endoplasmic reticulum and basal laminae thickness when all 18 cases were compared with the controls....... There was no significant difference when the magnesium group, the placebo group and the control group were compared separately. The present study suggests that magnesium supplement has a beneficial effect on fetal growth in pregnancy-induced hypertension. With regard to the light and electron microscopic changes we were...

  11. The CHIPS Randomized Controlled Trial (Control of Hypertension in Pregnancy Study): Is Severe Hypertension Just an Elevated Blood Pressure?

    Magee, Laura A.; von Dadelszen, Peter; Singer, Joel; Lee, Terry; Rey, Evelyne; Ross, Susan; Asztalos, Elizabeth; Murphy, Kellie E.; Menzies, Jennifer; Sanchez, Johanna; Gafni, Amiram; Helewa, Michael; Hutton, Eileen; Koren, Gideon; Lee, Shoo K.; Logan, Alexander G.; Ganzevoort, Wessel; Welch, Ross; Thornton, Jim G.; Moutquin, Jean-Marie

    2016-01-01

    To determine whether clinical outcomes differed by occurrence of severe hypertension in the international CHIPS trial (Control of Hypertension in Pregnancy Study), adjusting for the interventions of less tight (target diastolic blood pressure [dBP] 100 mmHg) versus tight control (target dBP 85

  12. Prevalence of prehypertension and hypertension and associated risk factors among Turkish adults: Trabzon Hypertension Study.

    Erem, Cihangir; Hacihasanoglu, Arif; Kocak, Mustafa; Deger, Orhan; Topbas, Murat

    2009-03-01

    To estimate the prevalence, awareness and control of prehypertension (preHT) and hypertension (HT) as defined by JNC-7 criteria in the Trabzon Region and its associations with demographic factors (age, sex, obesity, marital status, reproductive history in women and level of education), socioeconomic factors (household income and occupation), family history of selected medical conditions (diabetes, hypertension, obesity and cardiovascular disease), lifestyle factors (smoking habits, physical activity and alcohol consumption) in the adult population. In this cross-sectional survey, a sample of households was systematically selected from the central province of Trabzon and its nine towns. A total of 4809 adult subjects (2601 women and 2208 men) were included in the study. Demographic and socioeconomic factors, family history of selected medical conditions, and lifestyle factors were obtained for all participants. Systolic blood pressure (BP) and diastolic BP levels were measured for all subjects. The persons included in the questionnaire were invited to the local medical centers for blood examination between 08:00-10:00 following 12 hours of fasting. The levels of serum glucose (FBG), total cholesterol (Total-C), high density cholesterol (HDL-C), low density cholesterol (LDL-C) and triglycerides were measured with autoanalyzer. Definition and classification of HT was performed according to guidelines from the US JNC-7 report. Prevalence, awareness, treatment and control of HT were assessed. The prevalences of HT and preHT were 44.0% (46.1% in women and 41.6% in men) and 14.5% (12.6% in women and 16.8% in men), respectively. Overall, only 41% of the hypertensive individuals had been previously diagnosed. Furthermore, 54.5% of the hypertensive subjects were being treated with antihypertensive drugs (AHD), but only 24.3% of treated subjects had their BP adequately controlled. Among all hypertensive subjects (known and newly diagnosed), only 5.43% had their BP under

  13. Are thiazides effective on hypertensive vertigo? A preliminary study.

    Eryaman, Esra; Gökcan, Gökçen; Parmaksız, Ergün; Acar, Nurhan Ozdemir; Ozlüoğlu, Levent Naci

    2012-01-01

    In this study, we aimed to investigate whether the symptoms of vertigo related to hypertension resulted from endolymphatic hydrops and the efficacy of the thiazides in the treatment. A total of 24 vertigo patients without peripheric or central vestibular pathologies or hyperlipidemia were included. The study group comprised 15 patients with hypertension, including nine with regulated non-insulin-dependent diabetes mellitus (DM). The control group comprised nine patients without hypertension or DM. The patients in the study group received hydrochlorothiazide treatment. The European Evaluation of Vertigo Scale (EEVS) and Vertigo Handicap Questionnaire (VHQ), puretone audiometry, tympanometry, electronystagmography (ENG) for nystagmus tests, oculomotor tests, and caloric test were carried out initially and at three weeks for both groups. The results of the study group were compared to those of the control group. There was a statistically significant decrease in the scores of EEVS and VHQ at three weeks in the study group, compared to the baseline scores (for both groups p≤0.01). Our study results showed that thiazides alleviated vertigo symptoms in hypertensive patients, as measured by qualitative methods (i.e. EEVS, VHQ), but not with quantitative measurements (i.e. ENG).

  14. Hypertension control in industrial employees: findings from SHIMSCO study

    Alireza Khosravi

    2012-03-01

    Full Text Available Background: Hypertension prevention and control are among the most important public health priorities. We evaluated the impacts of a workplace intervention project "Stop Hypertension in Mobarakeh Steel Company" (SHIMSCO on controlling hypertension in industrial workers. Methods: The study was carried out in Mobarakeh Steel Company in Isfahan among 7286 male workers and employees. All individuals were evaluated for the presence of hypertension (HTN. According to examinations, 500 subjects with  systolic blood pressure (SBP ≥ 140 mmHg, and/or diastolic blood pressure (DBP ≥ 90 mmHg, and/or those using antihypertensive medications were confirmed to have HTN and thus included in this study. They were questioned for sociodemographic characteristics, past medical history and medication use. They received an educational program including healthy lifestyle and self-care recommendations of HTN management and control as well as training for accurate blood pressure measurement and home monitoring for two years. SBP, DBP, weight, height and routine lab tests were measured for all hypertensive subjects before and after the interventions. Paired t-test, generalized estimation equation (GEE and ordinary linear regression (OLR were used for statistical analysis in SPSS. Results: The comparison of SBP and DBP before and after the educational program showed significant reductions in both parameters (-7.97 ± 14.72 and -2.66 ± 9.96 mmHg, respectively. However, a greater decrease was detected in case of DBP. GEE showed SBP and DBP to decrease about -0.115 and -0.054 mmHg/month. OLR also revealed reductions of 4.88 and 2.57 mmHg respectively in SBP and DBP upon adding each antihypertensive drug. Conclusion: SHIMSCO, a 3-year interventional project in workplaces, was effective in reducing SBP and DBP among hypertensive employees and workers. We conclude that implementing simple educational programs in worksites can improve the management and control of

  15. Case Study: Intra-abdominal hypertension | Veldsman | South ...

    South African Journal of Clinical Nutrition. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 27, No 2 (2014) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register. Case Study: Intra-abdominal hypertension.

  16. The CHIPS Randomized Controlled Trial (Control of Hypertension in Pregnancy Study): Is Severe Hypertension Just an Elevated Blood Pressure?

    Magee, Laura A; von Dadelszen, Peter; Singer, Joel; Lee, Terry; Rey, Evelyne; Ross, Susan; Asztalos, Elizabeth; Murphy, Kellie E; Menzies, Jennifer; Sanchez, Johanna; Gafni, Amiram; Helewa, Michael; Hutton, Eileen; Koren, Gideon; Lee, Shoo K; Logan, Alexander G; Ganzevoort, Wessel; Welch, Ross; Thornton, Jim G; Moutquin, Jean-Marie

    2016-11-01

    To determine whether clinical outcomes differed by occurrence of severe hypertension in the international CHIPS trial (Control of Hypertension in Pregnancy Study), adjusting for the interventions of "less tight" (target diastolic blood pressure [dBP] 100 mm Hg) versus "tight" control (target dBP 85 mm Hg). In this post-hoc analysis of CHIPS data from 987 women with nonsevere nonproteinuric preexisting or gestational hypertension, mixed effects logistic regression was used to compare the following outcomes according to occurrence of severe hypertension, adjusting for allocated group and the influence of baseline factors: CHIPS primary (perinatal loss or high-level neonatal care for >48 hours) and secondary outcomes (serious maternal complications), birth weight hypertension that was associated with all outcomes examined except for maternal readmission (P=0.20): CHIPS primary outcome, birth weight hypertension and serious maternal complications was seen only in less tight control (P=0.02). Adjustment for preeclampsia (464, 47.3%) did not negate the relationship between severe hypertension and the CHIPS primary outcome (Phypertension is a risk marker for adverse maternal and perinatal outcomes, independent of BP control or preeclampsia co-occurrence. URL: http://pre-empt.cfri.ca/. Unique identifier: ISRCTN 71416914. URL: https://www.clinicaltrials.gov/. Unique identifier: NCT01192412. © 2016 The Authors.

  17. Neurocognitive disorder in hypertensive patients. Heart-Brain Study.

    Vicario, A; Cerezo, G H; Del Sueldo, M; Zilberman, J; Pawluk, S M; Lódolo, N; De Cerchio, A E; Ruffa, R M; Plunkett, R; Giuliano, M E; Forcada, P; Hauad, S; Flores, R

    2018-02-15

    The relation between hypertension and cognitive impairment is an undisputable fact. The aims of this study were to determine the prevalence of cognitive impairment in hypertensive patients, to identify the most affected cognitive domain, and to observe the association with different parameters of hypertension and other vascular risk factors. A multicentre study was carried out, and 1281 hypertensive patients of both genders and ≥21 years of age were included. Data on the following parameters were obtained: cognitive status (Minimal Cognitive Examination), behavioural status (Hospital Anxiety and Depression Scale), blood pressure, anthropometry, and biochemical profile. The average age was 60.2±13.5 years (71% female), and the educational level was 9.9±5.1 years. Global cognitive impairment was seen in 22.1%, executive dysfunction in 36.2%, and semantic memory impairment in 48.9%. Cognitive impairment was higher in males (36.8% vs. 30.06%) within both the 70-79-year-old and the ≥80-year-old (50% vs. 40%) age groups. Abnormal Clock Drawing Test results were related to high pulse pressure (p24), 29.4% presented executive dysfunction, and 41.5% semantic memory impairment. Cognitive impairment was higher in hypertensive patients than in the general population. Executive functions and semantic memory were the most affected cognitive domains. High systolic blood pressure and pulse pressure were associated with abnormal results in cognitive tests. Copyright © 2018 SEH-LELHA. Publicado por Elsevier España, S.L.U. All rights reserved.

  18. Comparisons of hypertension-related costs from multinational clinical studies.

    Mullins, C Daniel; Sikirica, Mirko; Seneviratne, Viran; Ahn, Jeonghoon; Akhras, Kasem S

    2004-01-01

    This study identifies and compares the individual cost components of hospital and ambulatory services that manage the care of hypertensive patients in eight countries: the US, the UK, France, Spain, Germany, Italy, Canada and Australia. Hypertension-related costs are classified according to four major cardiovascular events: (i) acute myocardial infarction; (ii) congestive heart failure; (iii) stroke; and (iv) renal failure, which was subdivided into renal failure treated by dialysis and renal failure treated by kidney transplantation. To make cross-country costs comparisons, we used the DRG codes used in the US and DRG-like codes from each country. US cost information was obtained from hypertension data available from the literature and health economics researchers. For costs in other countries, we consulted with national health economics experts in each country, used analyses by the Research Triangle Institute, and performed Medline and international literature searches. When available, we obtained information from the countries' public and private nationally representative data sources. For cross-country currency adjustments, all currencies were converted using the Purchasing Power Parities from the Organisation for Economic Cooperation and Development, and then converted into inflation-adjusted year 2000 US dollars. There exists considerable variation in hypertension-related costs from multinational clinical studies. This study documents that costs are generally higher in the US than in other countries; however, this is not always true. In particular, costs of treating heart failure in France and the costs of renal failure without transplantation in Germany and the UK are relatively high. While analysing multinational hypertensive cost data, this study also addresses the impact of cross-country cost variations on cost analyses. During the last decade, drug-development researchers have drawn extensively upon multinational trials to resolve enrollment problems and

  19. Barriers to treatment and control of hypertension among hypertensive participants: A community based cross-sectional mixed method study in municipalities of Kathmandu, Nepal

    Surya Devkota

    2016-08-01

    Full Text Available AbstractIntroduction: Despite the established evidence on benefits of controlling raised blood pressure and development of several guidelines on detection and management of hypertension, people often have untreated or uncontrolled hypertension. In this context, we undertook this study to identify the barriers existing in hypertension treatment and control in the municipalities of Kathmandu district in Nepal. Methods: This was a community based, cross-sectional mixed method study conducted in the municipalities of Kathmandu district in Nepal between January and July 2015. Among 587 randomly selected participants, the aware hypertensive participants were further assessed for the treatment and control of hypertension. For qualitative component, 20 participants having uncontrolled hypertension took part in two focused group discussions and two cardiac physicians participated in in-depth interviews.Results: Out of 587 participants screened, 191 (32.5% were identified as hypertensive. Among 191 hypertensive participants, 118 (61.8% were aware of their problem. Of the 118 aware hypertensive participants, 93 (78.8% were taking medicines, and among those treated, 46 (49.6% had controlled hypertension. Proportions of participants taking anti-hypertensive medications varied significantly with age groups, ethnicity, occupation and income. Hypertension control was significantly associated with use of combination therapy, adherence to medication, follow-up care, counseling by healthcare providers and waiting time in hospital. Being worried that the medicine needs to be taken life-long, perceived side effects of drugs, non-adherence to medication, lost to follow-up, inadequate counseling from physician, and lack of national guidelines for hypertension treatment were the most commonly cited barriers for treatment and control of hypertension in qualitative component of the research.Conclusion: Large proportion of the hypertensive population has the untreated and

  20. Associations between traffic noise, particulate air pollution, hypertension, and isolated systolic hypertension in adults: the KORA study.

    Babisch, Wolfgang; Wolf, Kathrin; Petz, Markus; Heinrich, Joachim; Cyrys, Josef; Peters, Annette

    2014-05-01

    Studies on the association between traffic noise and cardiovascular diseases have rarely considered air pollution as a covariate in the analyses. Isolated systolic hypertension has not yet been in the focus of epidemiological noise research. The association between traffic noise (road and rail) and the prevalence of hypertension was assessed in two study populations with a total of 4,166 participants 25-74 years of age. Traffic noise (weighted day-night average noise level; LDN) at the facade of the dwellings was derived from noise maps. Annual average PM2.5 mass concentrations at residential addresses were estimated by land-use regression. Hypertension was assessed by blood pressure readings, self-reported doctor-diagnosed hypertension, and antihypertensive drug intake. In the Greater Augsburg, Germany, study population, traffic noise and air pollution were not associated with hypertension. In the City of Augsburg population (n = 1,893), where the exposure assessment was more detailed, the adjusted odds ratio (OR) for a 10-dB(A) increase in noise was 1.16 (95% CI: 1.00, 1.35), and 1.11 (95% CI: 0.94, 1.30) after additional adjustment for PM2.5. The adjusted OR for a 1-μg/m3 increase in PM2.5 was 1.15 (95% CI: 1.02, 1.30), and 1.11 (95% CI: 0.98, 1.27) after additional adjustment for noise. For isolated systolic hypertension, the fully adjusted OR for noise was 1.43 (95% CI: 1.10, 1.86) and for PM2.5 was 1.08 (95% CI: 0.87, 1.34). Traffic noise and PM2.5 were both associated with a higher prevalence of hypertension. Mutually adjusted associations with hypertension were positive but no longer statistically significant.

  1. A prospective study of brain natriuretic peptide levels in three subgroups: Stroke with hypertension, stroke without hypertension, and hypertension alone

    Cakir Zeynep

    2010-01-01

    Full Text Available Aim: To study brain natriuretic peptide (BNP levels in three subgroups: patients having stroke with hypertension (HT, those having stroke without HT, and those with HT alone. We also tried to identify whether BNP levels predict the length of stay in hospital and mortality. Materials and Methods: The groups were formed by patients who had been admitted to the emergency department in the first 4-12 h after the onset of symptoms. There were 30 stroke patients with a history of HT (group I, 30 stroke patients without a history of HT (group II, and 20 HT patients without stroke (group III. Patients with congestive heart failure, chronic cor pulmonale, severe valvular heart disease, chronic renal failure, liver insufficiency, diabetes mellitus, atrial fibrillation, and those with a history of stroke were excluded from the study since these diseases can affect the plasma BNP levels. Results: The demographic characteristics, except the age distribution, were similar among the groups. The mean BNP levels in the three groups were 168.8 ± 223.9 pg/ml, 85.0 ± 75.1 pg/ml, and 84.8 ± 178.3 pg/ml, respectively. The differences between the groups were statistically significant. Conclusion: The mean BNP levels were affected by HT and/or stroke. The simultaneous presence of HT and stroke results in a more significant increase BNP than the presence of either stroke or HT alone. When diseases that can affect the plasma BNP levels are excluded, the BNP levels in stroke patients without a history of HT are similar to the levels seen in patients with only HT.

  2. Clinical factors associated with readmission for postpartum hypertension in women with pregnancy-related hypertension: a nested case control study.

    Hirshberg, A; Levine, L D; Srinivas, S K

    2016-05-01

    To evaluate the association between mode of delivery and length of labor on readmission for postpartum hypertension in women with pregnancy-related hypertension. Nested case control study within a cohort of 99 women with pregnancy-related hypertension who delivered at our institution between 2005 and 2009. Data were abstracted for clinical and labor information. Mode of delivery and length of labor were compared between women with previously diagnosed pregnancy-related hypertension readmitted within 4 weeks post partum (25 cases) and those not readmitted (74 controls). Categorical and continuous variables were compared using χ(2) and T-tests, respectively. Multivariable logistic regression controlled for confounders. Hypertension readmission was not associated with mode of delivery (cases: 10(40%) spontaneous vaginal delivery, 15(60%) cesarean delivery; controls: 38(51%) spontaneous vaginal delivery, 36(49%) cesarean delivery, P=0.33). Length of labor appeared longer in cases, with a trend toward significance (median: 15.5 [7,28] h vs 10.75 [5.8,15.9] h, P=0.12) and was significantly associated with readmission after controlling for delivery mode, induction and parity (adjusted odds ratio=1.06 [1 to 1.12], P=0.048). Readmitted patients were less likely to have initially been started on antihypertensive medications after controlling for age, race and chronic hypertension (adjusted odds ratio=0.23 [0.06 to 0.88], P=0.03). Postpartum readmission for hypertension in women with known pregnancy-related hypertension is not associated with mode of delivery, appears increased in those with longer length of labor and decreased in those initially started on antihypertensive medications. This provides targets for future research to continue to improve transitions of care and reduce preventable readmissions.

  3. A review of population-based studies on hypertension in ghana

    Addo, J.; Agyemang, C.; Smeeth, L.; de-Graft Aikins, A.; Edusei, A. K.; Ogedegbe, O.

    2012-01-01

    Hypertension is becoming a common health problem worldwide with increasing life expectancy and increasing prevalence of risk factors. Epidemiological data on hypertension in Ghana is necessary to guide policy and develop effective interventions. A review of population-based studies on hypertension

  4. Major inducing factors of hypertensive complications and the interventions required to reduce their prevalence: an epidemiological study of hypertension in a rural population in China

    Xiao Jianming

    2011-05-01

    Full Text Available Abstract Background The complications of hypertension cause severe health problems in rural areas in China. We (i screened the major factors inducing hypertensive complications and provided intervention measures; and (ii verified the efficacy of the New Rural Cooperative Medical Scheme (NRCMS; a medical insurance scheme for rural residents for hypertension management. Methods A survey was conducted in the villages of Yunnan (an underdeveloped province in southwest China. The NRCMS was initiated there in 2005. Data were collected through questionnaires, physical examination, electrocardiography, as well as blood and urine tests. To detect factors inducing hypertension complications, a generalized estimating equations model was developed. Multivariable logistic regression was used to analyze influencing factors for hypertension control. Results Poor management of hypertension was observed in women. Being female, old, poorly educated, a smoker, ignorant of the dangerousness of hypertension, and having uncontrolled hypertension made patients more prone to hypertension complications. Combination therapy with ≥2 drugs helped control hypertension, but most rural patients disliked multidrug therapy because they considered it to be expensive and inconvenient. The NRCMS contributed little to reduce the prevalence of complications and improve control of hypertension. Conclusions The present study suggested that the NRCMS needs to be reformed to concentrate on early intervention in hypertension and to concentrate on women. To increase hypertension control in rural areas in China, compound products containing effective and inexpensive drugs (and not multidrug therapy are needed.

  5. Major inducing factors of hypertensive complications and the interventions required to reduce their prevalence: an epidemiological study of hypertension in a rural population in China.

    Zhang, Min; Meng, Yong; Yang, Yongli; Liu, Yancai; Dong, Caiqin; Xiao, Jianming; Zhao, Ling; Li, Fang

    2011-05-11

    The complications of hypertension cause severe health problems in rural areas in China. We (i) screened the major factors inducing hypertensive complications and provided intervention measures; and (ii) verified the efficacy of the New Rural Cooperative Medical Scheme (NRCMS; a medical insurance scheme for rural residents) for hypertension management. A survey was conducted in the villages of Yunnan (an underdeveloped province in southwest China). The NRCMS was initiated there in 2005. Data were collected through questionnaires, physical examination, electrocardiography, as well as blood and urine tests. To detect factors inducing hypertension complications, a generalized estimating equations model was developed. Multivariable logistic regression was used to analyze influencing factors for hypertension control. Poor management of hypertension was observed in women. Being female, old, poorly educated, a smoker, ignorant of the dangerousness of hypertension, and having uncontrolled hypertension made patients more prone to hypertension complications. Combination therapy with ≥ 2 drugs helped control hypertension, but most rural patients disliked multidrug therapy because they considered it to be expensive and inconvenient. The NRCMS contributed little to reduce the prevalence of complications and improve control of hypertension. The present study suggested that the NRCMS needs to be reformed to concentrate on early intervention in hypertension and to concentrate on women. To increase hypertension control in rural areas in China, compound products containing effective and inexpensive drugs (and not multidrug therapy) are needed.

  6. Hypertension and type 2 diabetes: a cross-sectional study in Morocco (EPIDIAM Study).

    Berraho, Mohamed; El Achhab, Youness; Benslimane, Abdelilah; El Rhazi, Karima; Chikri, Mohamed; Nejjari, Chakib

    2012-01-01

    In Morocco, there are no studies that focused on the hypertension and its associated risk factors through patients with type 2 diabetes. Different findings show that the frequency of type 2 diabetes has risen rapidly in Morocco. The main objective of this study was to assess the prevalence of hypertension and its associated risk factors among a group of patients with type 2 diabetes and to examine the level of control of hypertension among type 2 diabetic patients with hypertension. A cross-sectional study was carried out on 525 type 2 diabetics in three Moroccan regions. The structured questionnaire was used to gather information on sociodemographic variables, history of hypertension, use of anti-hypertensive medications and duration of diabetes. Anthropometric measurements including weight and height were measured by trained staff. Blood pressure was measured using standardized sphygmomanometers. The prevalence of hypertension was 70.4%. The logistic regression indicated that hypertension was positively associated with age (peducation, counseling and behavioral interventions designed to modify lifestyle such as increasing physical activity and adopting recommended dietary changes, as well as compliance with medications.

  7. Hypertension awareness and control among young adults in the national longitudinal study of adolescent health.

    Gooding, Holly C; McGinty, Shannon; Richmond, Tracy K; Gillman, Matthew W; Field, Alison E

    2014-08-01

    Young adults are less likely than older adults to be aware they have hypertension or to be treated for hypertension. To describe rates of hypertension awareness and control in a cohort of young adults and understand the impact of health insurance, utilization of preventive care, and self-perception of health on rates of hypertension awareness and control in this age group. Cross-sectional study of 13,512 young adults participating in Wave IV of the National Longitudinal Study of Adolescent Health in 2007-2008. We defined hypertension as an average of two measured systolic blood pressures (SBP) ≥ 140 mmHg, diastolic blood pressures (DBP) ≥ 90 mmHg, or self-report of hypertension. We defined hypertension awareness as reporting having been told by a health care provider that one had high blood pressure, and assessed awareness among those with uncontrolled hypertension. We considered those aware of having hypertension controlled if their average measured SBP was young adults with hypertension, 2,531 (76%) were uncontrolled, and 1,893 (75%) of those with uncontrolled hypertension were unaware they had hypertension. After adjustment for age, sex, race/ethnicity, weight status, income, education, alcohol and tobacco use, young adults with uncontrolled hypertension who had (vs. didn't have) routine preventive care in the past 2 years were 2.4 times more likely (95% confidence interval [CI] 1.68-3.55) to be aware, but young adults who believed they were in excellent (vs. less than excellent) health were 64% less likely to be aware they had hypertension (OR 0.36, 95% CI 0.23-0.57). Neither preventive care utilization nor self-rated health was associated with blood pressure control. In this nationally representative group of young adults, rates of hypertension awareness and control were low. Efforts to increase detection of hypertension must address young adults' access to preventive care and perception of their need for care.

  8. Association of socioeconomic status with diagnosis, treatment and control of hypertension in diabetic hypertensive individuals in Bangladesh: a population-based cross-sectional study.

    Rahman, Mosiur; H, Syed Emdadul; Islam, Md Jahirul; Mostofa, Md Golam; Saadat, Khandakar Asm

    2015-10-01

    This study aimed to examine if socioeconomic status could affect the likelihood of diagnosis, treatment and control of hypertension in diabetic hypertensive individuals. Cross-sectional nationally representative study. Bangladesh. This paper used data from the 2011 Bangladesh Demographic Health Survey. The analyses were based on the responses of 339 diabetes hypertensive individuals. Diagnosis, treatment and control of hypertension. The age-adjusted prevalence of hypertension in diabetes individuals was 38.4% in the study population. Among diabetic hypertensive subjects only 65.7% had been diagnosed, 58.4% were receiving treatment and 42% controlled their hypertension. Individuals from high socioeconomic status (AOR 2.60; 95% CI 1.16-5.83) had an increased likelihood of reporting diagnosis of hypertension. Individuals from medium (AOR 2.22; 95% CI 1.11-4.46) and high socioeconomic status (AOR 3.47; 95% CI 1.59-7.58) had increased chance of receiving treatment. In addition, individuals belonging to high socioeconomic status (AOR 2.53; 95% CI 1.14-5.63) were more likely to report of controlling hypertension. This study indicated that hypertension is more prevalent among diabetic patients. Furthermore, diabetic hypertensive patients from the low socioeconomic status group are also less likely to be diagnosed and also less likely to receive treatment for hypertension. In addition, diabetic hypertensive patients from the low socioeconomic status were less likely to control hypertension compared with an individual belonging to the high socioeconomic status group. This reduced likelihood of receiving proper treatment will lead to a rapid increase in the prevalence of macrovascular and microvascular diseases among diabetic hypertensive patients.

  9. Magnesium supplement in pregnancy-induced hypertension. A clinicopathological study

    Rudnicki, M; Junge, Jette; Frølich, A

    1990-01-01

    as a double-blind randomized controlled study in which 11 women were allocated to magnesium and 7 to placebo treatment. The treatment comprised a 48-hour intravenous magnesium/placebo infusion followed by daily oral magnesium/placebo intake until one day after delivery. Magnesium supplement increased birth....... There was no significant difference when the magnesium group, the placebo group and the control group were compared separately. The present study suggests that magnesium supplement has a beneficial effect on fetal growth in pregnancy-induced hypertension. With regard to the light and electron microscopic changes we were...... unable to demonstrate any significant difference between the magnesium, placebo and control groups....

  10. STUDY ON PLATELET INDICES IN PREGNANCY INDUCED HYPERTENSION

    Rabi a Parveen

    2015-10-01

    Full Text Available INTRODUCTION : Pregnancy induced hypertension includes gestational hypertension, preeclampsia, and eclampsia. In PIH, lower the platelet count, greater are maternal and fetal morbidity and mortality. Recent studies suggest that platele t parameters like platelet indices are most simple and cost effective method for prediction of PIH, way before the appearance of derangements in PT, APTT, TT values so we undertook this study with an aim to see an association between platelet indices and pregnancy induced hypertension. MATERIAL AND METHOD : This was prospective analytical case control study. Study included 125 cases, who were diagnosed as PIH with B.P. > 140/90 mmHg, detected after 20 weeks of pregnancy. Under all aseptic precautions samples were collected randomly in EDTA vials . Samples were analysed for platelet indices . RESULT : Maximum number of cases of Preeclampsia (88.57% & Eclampsia (87.5% were fo und in age group of 21 to 25 . Controls were of same age group i.e. 21 to 25 years. It was observed that platelet count showed gradual decrease in eclampsia (1.44580± 36,210 & pre - e clampsia patients (1.97850± 39,010 as compared to normotensive subjects (2.42620± 40,412. MPV showed gradual increase in eclampsia ( 10.49 ±1.12 & pre - eclampsia ( 9.14 ±0.612 patients as compared to normotensive subjects ( 8.422 ±0.743. PDW value also shows gradual increase in eclampsia ( 18.39 ±2.62 & pre - eclampsia ( 16.29 ±2.34 p atients as compared to normotensive subjects ( 12.09 ±2.53. CONCLUSION : Study showed that platelet indices were important, simple, effortless and cost effective investigations which can be used for early recognition of preventable eclampsia complications.

  11. The study of risk in pulmonary arterial hypertension

    Gerald Simonneau

    2012-09-01

    Full Text Available A growing body of published evidence exists on the risk factors for disease progression in pulmonary arterial hypertension (PAH. The Scientific Steering Committee for the Study of Risk in PAH was established to bring together leading clinical and statistical experts in PAH and risk modelling, for the purpose of advancing the understanding of the risk of development and progression of PAH. Herein, we discuss the impact of this information on three key areas: 1 clinical decision-making; 2 policy and reimbursement; and 3 future trials and research.

  12. Risk of post-pregnancy hypertension in women with a history of hypertensive disorders of pregnancy: nationwide cohort study

    Behrens, Ida; Basit, Saima; Melbye, Mads; Lykke, Jacob A; Wohlfahrt, Jan; Bundgaard, Henning; Thilaganathan, Baskaran; Boyd, Heather A

    2017-01-01

    Objectives To determine how soon after delivery the risk of post-pregnancy hypertension increases in women with hypertensive disorders of pregnancy and how the risk evolves over time.Design Nationwide register based cohort study.Setting Denmark.Populations 482 972 primiparous women with a first live birth or stillbirth between 1995 and 2012 (cumulative incidence analyses), and 1 025 118 women with at least one live birth or stillbirth between 1978 and 2012 (Cox regression analyses).Main outco...

  13. Captopril radionuclide test in renovascular hypertension: a European multicentre study

    Fommei, E.; Ghione, S.; Hilson, A.J.W.; Mezzasalma, L.; Oei, H.Y.; Piepsz, A.; Volterrani, D.

    1993-01-01

    The efficacy of renal scintigraphy with technetium-99m DTPA before and after captopril was evaluated in a multicentre study. All 380 hypertensive patients in the study underwent renal arteriography; 125 had renal arterial stenosis ≥70%, and 54 had a technically successful intervention to correct the stenosis. The post-captopril study had a sensitivity of 93% and a specificity of 100% for predicting blood pressure response to intervention, if renal function was normal and a combination of quantitative parameters was applied. In the entire population renal artery stenosis ≥70% was detected with a sensitivity of 83% and a specificity of 93% if renal function was normal. In patients with abnormal renal function the performance of the test was worse, owing to a lower specificity which could be increased by using only time parameters. The performance of the test was optimal when the post-captopril findings were examined; no improvement was achieved by evaluation of the changes induced by captopril from the baseline. The test can thus be simplified by performing only a post-captopril study for routine use: a negative test would exclude a curable form of renovascular hypertension in right angle 80% and a positive test would predict it in right angle 90% of the patients selected for suspicion of the disease. Usefulness of the scintigraphic test for monitoring the clinical results of intervention is suggested by correlating post-intervention outcome with pre- and post-intervention scintigraphic results. (orig./MG)

  14. Milan hypertensive rat as a model for studying cation transport abnormality in genetic hypertension

    Ferrari, P.; Barber, B.R.; Torielli, L.; Ferrandi, M.; Salardi, S.; Bianchi, G.

    1987-01-01

    Environmental factors, genetic polymorphisms, and different experimental designs have been the main impediments to evaluating a genetic association between cell membrane cation transport abnormalities and human essential or genetic hypertension. We review the results obtained in the Milan hypertensive strain of rats (MHS) and in its appropriate control normotensive strain (MNS) to illustrate our approach to defining the role of cation transport abnormality in a type of genetic hypertension. Before the development of a difference in blood pressure between the two strains, the comparison of kidney and erythrocyte functions showed that MHS had an increased glomerular filtration rate and urinary output, and lower plasma renin and urine osmolality. Kidney cross-transplantation between the strains showed that hypertension is transplanted with the kidney. Proximal tubular cell volume and sodium content were lower in MHS while sodium transport across the brush border membrane vesicles of MHS was faster. Erythrocytes in MHS were smaller and had lower sodium concentration, and Na+-K+ cotransport and passive permeability were faster. The differences in volume, sodium content, and Na+-K+ cotransport between erythrocytes of the two strains persisted after transplantation of bone marrow to irradiated F1 (MHS X MNS) hybrids. Moreover, in normal segregating F2 hybrid populations there was a positive correlation between blood pressure and Na+-K+ cotransport. These results suggest a genetic and functional link in MHS between cell membrane cation transport abnormalities and hypertension. Thus, erythrocyte cell membrane may be used for approaching the problem of defining the genetically determined molecular mechanism underlying the development of a type of essential hypertension. 35 references

  15. Rationale and design of the screening of pulmonary hypertension in systemic lupus erythematosus (SOPHIE) study.

    Huang, Duo; Cheng, Yang-Yang; Chan, Pak-Hei; Hai, Jojo; Yiu, Kai-Hang; Tse, Hung-Fat; Wong, Ka-Lam; Fan, Katherine; Li, Ying Wah; Ng, Woon-Leung; Yim, Cheuk-Wan; Wong, Cheuk-Hon John; Tam, Lai-Shan; Wong, Priscilla C H; Wong, Chi-Yuen; Ho, Chup-Hei; Leung, Alexander M H; Mok, Chi-Chiu; Lam, Ho; Lau, Chak-Sing; Cheung, Tommy; Ho, Carmen; Law, Sharon W Y; Chan, Esther W; Yin, Li-Xue; Yue, Wen-Sheng; Mok, Toi Meng; Evora, Mario Alberto; Siu, Chung-Wah

    2018-01-01

    Current guideline-recommended screening for pulmonary hypertension in patients with systemic sclerosis has not been evaluated in systemic lupus erythematosus (SLE), which is disproportionately prevalent in Asians. This multicentre, cross-sectional screening study aims to study the prevalence of pulmonary hypertension among SLE patients using these guidelines, and identify independent predictors and develop a prediction model for pulmonary hypertension in SLE patients. SLE patients from participating centres will undergo an echocardiography- and biomarker-based pulmonary hypertension screening procedure as in the DETECT study. Standard right heart catheterisation will be provided to patients with intermediate or high echocardiographic probability of pulmonary hypertension. Those with low echocardiographic probability will rescreen within 1 year. The primary measure will be the diagnosis and types of pulmonary hypertension and prevalence of pulmonary hypertension in SLE patients. The secondary measures will be the predictors and prediction models for pulmonary hypertension in SLE patients. The estimated sample size is approximately 895 participants. The results of the SOPHIE study will be an important contribution to the literature of SLE-related pulmonary hypertension and may be immediately translatable to real clinical practice. Ultimately, this study will provide the necessary evidence for establishing universal guidelines for screening of pulmonary hypertension in SLE patients.

  16. A STUDY ON PLASMA 25 - HYDROXY VITAMIN D LEVELS AS A RISK FACTOR IN PRIMARY HYPERTENSION

    Ravinandana Gowda

    2015-07-01

    Full Text Available BACKGROUND: Recent research shows that vitamin D deficiency could be a risk factor in many chronic diseases like hypertension, diabetes mellitus, dyslipidemia, cardiovascular disease, some cancers, auto immune disease and tuberculosis. AIMS AND OBJECTIVES: To determine serum 25 - hydroxy vitamin D levels in patients with primary hypertension. This study also attempts to demonstrate an inverse co - relation between vitamin D levels and primary hypertension. MATERIALS AND METHOD S: 30 patients who are primary hype rtensive were selected, their vitamin D levels measured and the vitamin D levels were compared to age and sex matched non hypertensive controls. STATISTICAL METHODS: Descriptive and inferential statistical analysis has been carried out in the present study . ANOVA test and Chi - square test was applied for quantitative and qualitative data respectively to find significant associations between two variables. RESULTS: It is seen from this study that serum vitamin D levels was lower in hypertensive patients when compared to non - hypertensive controls. Hypertensive patients had lower levels of vitamin D with vitamin D status of deficiency in 50% of the cases and insufficiency in 43.3% of the cases and normal levels in 6.7% of the cases. Non hypertensive controls sho wed vitamin D status of normal in 66.7% of controls and insufficiency in 33.3% of the controls without deficiency. Age of the cases, duration of hypertension, systolic blood pressure and diastolic blood pressure inversely correlated to vitamin D levels. Bo dy mass index, diet of the patient, alcohol consumption, number of anti - hypertensive drugs, drug compliance, family history of hypertension and fundus status did not correlate to vitamin D levels. CONCLUSIONS: Based on the observations of the study, Vitami n D is an independent risk factor that is associated with primary or essential hypertension. The level of vitamin D also correlated inversely to age, duration of

  17. Genetic, physiological and comparative genomic studies of hypertension and insulin resistance in the spontaneously hypertensive rat

    Coan, P. M.; Hummel, O.; Diaz, A. G.; Barrier, M.; Alfazema, N.; Norsworthy, P. J.; Pravenec, Michal; Petretto, E.; Hübner, N.; Aitman, T. J.

    2017-01-01

    Roč. 10, č. 3 (2017), s. 297-306 ISSN 1754-8403 R&D Projects: GA ČR(CZ) GAP301/12/0696 Institutional support: RVO:67985823 Keywords : rat * congenic * genomic * hypertension * insulin resistance Subject RIV: EB - Gene tics ; Molecular Biology OBOR OECD: Endocrinology and metabolism (including diabetes, hormones) Impact factor: 4.691, year: 2016

  18. Study of determinants of nonadherence to anti-hypertensive medications in essential hypertension at a Teaching Hospital in Southern India

    R C Kumaraswamy

    2015-01-01

    Full Text Available Introduction: Hypertension is a chronic asymptomatic disease, often goes unnoticed for decades before it presents to the medical fraternity with devastating consequences. Low patient adherence is amenable for modification for better control of hypertension, if factors contributing to it are understood. Study was undertaken with the aims of assessing the factors responsible and their relative contributions toward nonadherence among hypertensives. Materials and Methods: We conducted a prospective observational study from August 2013 to August 2014. We included those, who attended the medicine outpatient department with a diagnosis of essential hypertension of more than 1 year duration. Results: A total of 516 patients were enrolled in the study, of which 132 (25.58% were nonadherent. Marital status (P = 0.017, socioeconomic status (P = 0.000, level of education (P = 0.034, such as, illiteracy was associated with highest level of nonadherence compared with those with pre-matric and undergraduate education, whereas those with post graduate level of education showed absolute adherence to drugs and domiciliary status (P = 0.045 had statistically significant association with nonadherence. Other factors like younger age and male sex were associated with a higher degree of nonadherence, however statistical significance could not be obtained.

  19. Study on inhibition of hypertension by low dose radiation

    Yamaoka, Kiyonori; Nakazono, Koichi; Watanabe, Nobukazu; Inoue, Masayasu.

    1992-01-01

    To elucidate the pathogenesis of hypertension, superoxide dismutase (HB-SOD) with high affinity for vascular endothelial cells was administered to spontaneously hypertensive rats (SHR). HB-SOD but not native SOD markedly decreased the blood pressure of SHR but not of control rats. The results suggest that regulation of superoxide and the related metabolites in and around vascular endothelial cells is important for controling blood pressure in hypertensive subjects. (author)

  20. Orthostatic hypertension as a predisposing factor for masked hypertension: the J-SHIPP study.

    Tabara, Yasuharu; Igase, Michiya; Miki, Tetsuro; Ohyagi, Yasumasa; Matsuda, Fumihiko; Kohara, Katsuhiko

    2016-09-01

    Masked hypertension (HT) is a known risk factor for cardiovascular outcomes. Postural blood pressure (BP) dysregulation is another BP phenomenon representing cardiovascular frailty. Given their several shared risk factors, we suspected an inter-relationship between these two BP phenomena. Here we investigated a possible relationship between masked HT and postural BP dysregulation in a general population. Study subjects were 884 apparently healthy individuals (aged 66.3±8.9 years). Masked HT was assessed on the basis of the ambulatory monitored average awake BP and office-measured BP values. Orthostatic BP change was measured at our office after a subject was asked to actively stand up. A strong inverse relationship was noted for orthostatic systolic BP (SBP) change and office-to-awake SBP differences (office-awake BP) (r=-0.422, P10 mm Hg, 3 min after standing (P=0.001), but not transient HT at only 1 min (P=0.767), was associated with greater office-to-awake SBP differences than in orthostatic normotensive subjects. Among apparently normotensive subjects, the frequency of masked HT was therefore significantly greater in subjects who showed OHT 3 min after standing (52.1%) compared with controls (27.5%) (odds ratio=3.01, P=0.001). We observed an intra-individual relationship between the postural BP change and the office-to-awake BP differences, and subjects who showed OHT were likely to have masked HT irrespective of antihypertensive treatment.

  1. Evaluation of Pulmonary Hypertension with CMR: Pulmonary Hypertension 
Patients and Healthy Volunteers Control Study

    Meng WANG

    2016-05-01

    Full Text Available Background and objective The clinical course of pulmonary hypertension (PH is one of progressive deterioration interspersed with episodes of acute decompensation. It is difficult to predict when patients will die because death may come either suddenly or slowly due to progressive heart failure. The aim of this study is to investigate morphology, function and hemodynamics in PH, compared with healthy people, and to investigate the clinical value of detection of PH by use of cardiac magnetic resonance (CMR parameters. Methods CMR was performed in 56 PH patients collected from Tianjin Medical University General Hospital from January 2012 to December 2014 and 22 healthy controls. The following parameters were calculated: right ventricle (RV end-diastolic volume (EDV, end-systolic volume (ESV, ejection fraction (EF, myocardial mass (MM, RV fractional area change (RVFAC, interventricular septal curvature (CIVS, left ventricular free wall curvature (CFW, and CIVS/CFW, main pulmonary artery (MPA positive peak velocity, maximal area, minimal area and distensibility. Comparisons of CMR measurements between PH patients and controls were analyzed by using the student t-tests. Receiver operating characteristic (ROC curve analysis was used to compare the PH diagnostic abilities for four parameters (MPA positive peak velocity, distensibility, curvature ratio, and RVFAC and combined CMR parameter. P<0.05 was considered significant. Results Compared with healthy controls, RV morphology, function and hemodynamics of PH group declined and deteriorate obviously. The ROC curve analysis showed that among the four parameters distensibility of MPA had the highest AUC value (AUC=0.95. Additionally, combined CMR parameter (positive peak velocity+distensibility+curvature ratio+RVFAC had even higher AUC (AUC=0.988. Conclusion Comprehensive CMR parameters is conducive to accurately reflect the overall state RV-pulmonary circulation in patients with PH.

  2. An Epidemiological Study Of Hypertension Amongst Children From Various Primary Schools Of Surat City

    Thakor H.G

    1998-01-01

    Full Text Available Research question: What is the prevalence of hypertension in school children aged 10 years and above? Objectives: 1. To find out the prevalence of hypertension. 2. To generate a profile of hypertensive cases. Study design: Cross-sectional. Setting: Selected primary schools run by Surat Manipal Corporation. Participants: School children aged 10 years and above. Sample size: 2250 children (1092 boys, 158girls Study variables: Age, sex, body weight, body mass index Outcome variables: Prevalence of hypertension. Statistical analysis: X2 test Results: Overall prevalence of hypertension in children was 2.3 percent, separately in girls and 0.9 percent in boys. Body weight above 40kgms and body mass index (BMI above 20 were differentiating points as children weighing more than 40kgms and/or with BMI more than 20 significantly higher prevalence of hypertension. Most of the cases were asymptomatic and also had no suggestive symptoms in the past.

  3. Hypertensive disease and renal hypertensions: renal structural and functional studies by using dynamic computed tomography

    Arabidze, G.G.; Pogrebnaya, G.N.; Todua, F.I.; Sokolova, R.I.; Kozdoba, O.A.

    1989-01-01

    Dynamic computed tomography was conducted by the original methods; the findings were analyzed by taking into account time-density curves which made it possible to gain an insight into the status of blood flow and filtration in each individual kidney. Computed tomography and dynamic computed tomography revealed that hypertensive disease was characterized by normal volume and thickness of the renal cortical layer and symmetric time-density curves, whereas a hypertensive type of chronic glomerulonephritis featured lower renal cartical layer thickness, reduced renal volume, symmetrically decrease amplitudes of the first and second peaks of the time-density curve, chronic pyelonephritis showed asymmetric time-density diagrams due to the lower density areas in the afflicted kidney

  4. The Effectiveness of Hypertensive Management Programs and Social Support in Primary Health Care Systems: Preliminary Study

    Pantip Sangprasert; Surasak Buranatrevedh; Duangnate Pipatsatitpong

    2016-01-01

    This quasi-experimental study used inclusion criteria obtaining samples taken from high-risk and grade I hypertensive patients aged 35 to 59 without hypertensive complications. The two related groups comprised 36 individuals. Both were enrolled in a hypertensive management program comprising health education strategies, respiratory training, advice on limiting salt and fat intake, exercise, group discussion with social support, telephon counseling, and home visits. Three perceptio...

  5. Hypertension: adherence to treatment in rural Bangladesh – findings from a population-based study

    Khanam, Masuma Akter; Lindeboom, Wietze; Koehlmoos, Tracey Lynn Perez; Alam, Dewan Shamsul; Niessen, Louis; Milton, Abul Hasnat

    2014-01-01

    Background: Poor adherence has been identified as the main cause of failure to control hypertension. Poor adherence to antihypertensive treatment is a significant cardiovascular risk factor, which often remains unrecognized. There are no previous studies that examined adherence with antihypertensive medication or the characteristics of the non-adherent patients in Bangladesh.Objective: This paper aims to describe hypertension and factors affecting adherence to treatment among hypertensive per...

  6. Diabetes and hypertension: experimental models for pharmacological studies

    van Zwieten, P. A.

    1999-01-01

    Since hypertensive and diabetes-mellitus frequently occur simultaneously there exists a requirement for animal models where both pathological entities are combined. The streptozotocin (STZ)-spontaneously hypertensive rat (STZ-SHR) and the obese Zucker rat are examples of animal models where

  7. Study of serum lipid profile in pregnancy induced hypertension in ...

    At recent times, there has been a great interest on the role of lipid metabolism in the development of pregnancy induced hypertension and pre-eclampsia ... Results: Mean serum triglyceride was higher in (Group 1) pregnant women with pregnancy induced hypertension than in Groups 2 and 3, this was however not ...

  8. Time trend in hypertension prevalence, awareness, treatment, and control in a contemporary cohort of HIV-infected patients: the HIV and Hypertension Study.

    De Socio, Giuseppe Vittorio; Ricci, Elena; Maggi, Paolo; Parruti, Giustino; Celesia, Benedetto Maurizio; Orofino, Giancarlo; Madeddu, Giordano; Martinelli, Canio; Menzaghi, Barbara; Taramasso, Lucia; Bonfanti, Paolo; Pucci, Giacomo; Schillaci, Giuseppe

    2017-02-01

    Hypertension control is often inadequate in HIV patients. In a contemporary, nationwide cohort of Italian HIV-infected adults, we assessed time trends in hypertension prevalence, awareness, treatment, and control. We also evaluated predictors of cardiovascular events and of new-onset hypertension. Multicenter prospective cohort study, sampling 961 consecutive HIV patients (71% men, mean age 46 ± 9 years, 30% hypertensive) examined in 2010-2014 and after a median follow-up of 3.4 years. Among hypertensive patients, hypertension awareness (63% at baseline and 92% at follow-up), treatment (54 vs. 79%), and control (35 vs. 59%) all improved during follow-up. The incidence of new-onset hypertension was 50.1/1000 person-years (95% confidence interval, 41.2-60.3). Multivariable-adjusted predictors of hypertension were age, BMI, estimated cardiovascular risk, blood pressure, and advanced HIV clinical stage.In total, 35 new cardiovascular events were reported during follow-up (11.1/1000 person-years). In a multivariate model, baseline cardiovascular risk and hypertensive status predicted incident cardiovascular events, whereas a higher CD4 cell count had a protective role. In treated hypertensive patients, the use of integrase strand transfer inhibitors at follow-up was associated with a lower SBP (average yearly change, -3.8 ± 1.6 vs. -0.9 ± 0.5 mmHg in integrase strand transfer inhibitor users vs. nonusers, respectively, P = 0.02). Hypertension awareness, treatment, and control rates all improved in adult Italian HIV patients over the last few years, although hypertension remains highly prevalent (41%) in middle-aged HIV patients, and significantly impacts cardiovascular morbidity. Traditional risk factors and advanced HIV disease predict new-onset hypertension, whereas CD4 cell count favorably affects future cardiovascular events.

  9. The metabolic syndrome and risk of myocardial infarction in familial hypertension (hypertension heredity in Malmö evaluation study).

    Fedorowski, Artur; Burri, Philippe; Hulthén, Lennart; Melander, Olle

    2009-01-01

    The aim of this study was to examine whether three main definitions of the metabolic syndrome (MetS)--WHO, National Cholesterol Education Program--Adult Treatment Panel III and International Diabetes Federation--identify the same individuals and are able to predict incident myocardial infarction (MI) in families with essential hypertension. The tested definitions were prospectively related to data on MI in a cohort of approximately 1700 individuals with overt essential hypertension and their normotensive first-degree relatives. At baseline, 616 participants had MetS, yet only 209 of them (33.9%) were identified by all definitions, and compatibility rate for each pair of definitions was approximately 50%. During follow-up (Tmean approximately 6.6 years) 53 participants developed MI and they were generally older and more dysmetabolic than the rest of the cohort. There were also more men, smokers and diabetic individuals in this group. After adjustment for all conventional cardiovascular risk factors, including hypertension and diabetes, only the National Cholesterol Education Program definition could predict the increased risk of MI [odds ratio (OR) = 2.2, confidence interval (CI) = 1.2-4.0, P = 0.01]. Among individual MetS components, incident MI was independently associated with three of them: low high-density lipoprotein-cholesterol (OR = 2.03, CI = 1.09-3.78, P = 0.025) insulin resistance (OR = 2.02, CI = 1.08-3.78, P = 0.028) and increased albumin excretion rate (OR = 1.24, CI = 0.99-1.55, P = 0.060). The presence of MetS in hypertensive and genetically hypertension prone individuals may signal the increased risk of future MI. However, only the National Cholesterol Education Program criteria appear to have a sufficient predictive accuracy.

  10. Definition and management of hypertension among Haitian immigrants: a qualitative study.

    Sanon, Marie-Anne; Mohammed, Selina A; McCullagh, Marjorie C

    2014-08-01

    Hypertension is a major health concern among Haitian immigrants, one of the largest Caribbean immigrant groups in the United States. Yet, little is known about how Hatian immigrants define and manage hypertension. For this qualitative study, face-to-face semi-structured interviews were conducted with 31 Haitian immigrants in Miami Dade County, Florida. Results indicated that most Haitian immigrants used the Haitian Creole word tansyon to represent hypertension. Tansyon was considered as either a normal condition of the human body or a maladi (illness). Both traditional biomedical and alternative approaches were used to manage hypertension. The findings show that how Haitian immigrants defined hypertension shaped their beliefs about its occurrence and the resulting management strategies used. Those who believed tansyon was a normal body condition did not take any management measures. Awareness and understanding of Haitian immigrants' beliefs about and approaches to hypertension management can enhance culturally sensitive care and improve health outcomes.

  11. Study of socio-demographic factors affecting prevalence of hypertension among bank employees of Surat City.

    Momin, Mohmmedirfan H; Desai, Vikas K; Kavishwar, Abhay B

    2012-01-01

    Cardiovascular diseases including hypertension are increasing in developing countries especially among high-risk group people like bank employees. A cross-sectional study of 1493 bank employees of Surat city was conducted during August, 2004 to September, 2005 to study the prevalence of hypertension among bank employees and the effects of socio-demographic factors on prevalence of hypertension. Data were analyzed using epi 6 software. The χ[2] -test was applied as a nonparametric test of statistical significance. Prevalence of hypertension was 30.4% and prehypertension was 34.5%. Out of 455 found as hypertensive, 258 (56.70%) were not having any symptoms at the time of examination. Prevalence was high among persons with age 50 years and above (48.5%); among male (32.5%) as compared to female (23.1%); among employees having small family size; among separated/divorcee person (40.0%). Prevalence of hypertension increased with seniority of the official position of bank employee with highest prevalence among managers (45.9%). Prevalence of hypertension was noted highest among the higher socioeconomic group; SEC I (35.0%) followed by class II (20.4%). Effects of different risk factors of hypertension were observed here. This study may help in identifying the common profile of hypertensive or persons at risk, which may further help in identifying the risk group and planning the group specific IEC interventions.

  12. Association between anthropometric indicators of adiposity and hypertension in a Brazilian population: Baependi Heart Study.

    Camila Maciel de Oliveira

    Full Text Available Recently, some studies have evaluated the role of adiposity measures in the prediction of hypertension risk, but the results are conflicting. Thus, the aim of this study was to compare which of the four indicators of adiposity (waist circumference-WC, body mass index-BMI, body adiposity index-BAI, and visceral adiposity index-VAI were better associated with hypertension in a Brazilian population.For this study, were selected 1627 individuals (both genders, and aged over 18 years resident in the municipality of Baependi, a city located in the Southeast of Brazil. WC, BMI, BAI and VAI were determined according to a standard protocol. Hypertension was defined as mean systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg, and/or antihypertensive drug use. The indicators of adiposity WC, BMI, BAI, and VAI were higher in hypertensive when compared to non-hypertensive individuals. In addition, WC and BMI were most strongly associated with hypertension in men and women, respectively. The area under the curve (AUC of WC was significantly higher than VAI in men. In women, both AUC of BMI and WC showed higher discriminatory power to predict hypertension than BAI and VAI.The indicators of adiposity WC and BMI were better associated with hypertension than BAI and VAI, in both genders, and it could be a useful tools for the screening of hypertensive patients.

  13. AN EPIDEMIOLOGICAL STUDY ON HYPERTENSION AND ITS DIETARY CORRELATES IN A RURAL POPULATION OF MEERUT

    Monika Gupta

    2012-07-01

    Full Text Available Background: Hypertension is the commonest cardiovascular disorder accounting for 20-50% of all cardiovascular deaths and it is a major health problem affecting most of the countries in the world. Objective: To find out the prevalence of hypertension and to assess the relation of dietary factors with hypertension Methodology: A Community based cross-sectional study was conducted in rural field practice area of department of Community Medicine, Subharti Medical College, Meerut. A personal house to house visit was made to each household selected by systematic random sampling technique and data was collected using a predesigned and pretested interview and examination schedule All the members from selected households were included in the study. Hypertension was defined as Systolic BP e”140mmHg and/or diastolic BP e” 90mmHg or subjects currently taking anti-hypertensive treatment. Total period of study was October 2009 to September 2011. Data was analysed in Microsoft excel using percentiles, Chi-square test and Chi-square test for trend. Results: The overall prevalence of hypertension was found to be 18%. A significant association was found between hypertension and type of diet and additional salt intake while no significant association was observed with frequency of intake of junk food. Conclusion: Prevalence of hypertension is found to be high (18% so there is a need to create awareness about hypertension in the community.

  14. AN EPIDEMIOLOGICAL STUDY ON HYPERTENSION AND ITS DIETARY CORRELATES IN A RURAL POPULATION OF MEERUT

    Monika Gupta

    2012-06-01

    Full Text Available Background: Hypertension is the commonest cardiovascular disorder accounting for 20-50% of all cardiovascular deaths and it is a major health problem affecting most of the countries in the world. Objective: To find out the prevalence of hypertension and to assess the relation of dietary factors with hypertension Methodology: A Community based cross-sectional study was conducted in rural field practice area of department of Community Medicine, Subharti Medical College, Meerut. A personal house to house visit was made to each household selected by systematic random sampling technique and data was collected using a predesigned and pretested interview and examination schedule All the members from selected households were included in the study. Hypertension was defined as Systolic BP e”140mmHg and/or diastolic BP e” 90mmHg or subjects currently taking anti-hypertensive treatment. Total period of study was October 2009 to September 2011. Data was analysed in Microsoft excel using percentiles, Chi-square test and Chi-square test for trend. Results: The overall prevalence of hypertension was found to be 18%. A significant association was found between hypertension and type of diet and additional salt intake while no significant association was observed with frequency of intake of junk food. Conclusion: Prevalence of hypertension is found to be high (18% so there is a need to create awareness about hypertension in the community.

  15. Pattern of left ventricular geometry in hypertension: a study of a ...

    Background: Hypertension is a leading cause of cardioxasular morbidity and mortality in Nigeria. The main aim of this study was to deterine the prevalence of left ventricular hypertrophy and left ventricular geometric patterns among hypertensives in Kano, Nigeria. Methods: The study was cross-sectional in design, and ...

  16. Hypertensive patients perception of their illness: A qualitative study ...

    PROMOTING ACCESS TO AFRICAN RESEARCH ... treatment and lifestyle changes recommendations in a primary care setting. ... Conclusion - Hypertensive patients need information during their encounter with health care providers on ...

  17. Control of Hypertension in STULONG - Twenty Years Lasting Primary Preventive Study

    Tomečková, Marie; Stanovská, Zuzana; Boudík, F.; Zvárová, Jana

    22 Suppl. 2, - (2004), s. 271 ISSN 0263-6352. [European Meeting on Hypertension /14./. 13.06.2004-17.06.2004, Paris] R&D Projects: GA MŠk LN00B107 Keywords : hypertension * primary preventive study Subject RIV: BB - Applied Statistics, Operational Research

  18. A review of population-based studies on hypertension in Ghana ...

    Background: Hypertension is becoming a common health problem worldwide with increasing life expectancy and increasing prevalence of risk factors. Epidemiological data on hypertension in Ghana is necessary to guide policy and develop effective interventions. Methods: A review of population-based studies on ...

  19. Hypertension control in a large multi-ethnic cohort in Amsterdam, The Netherlands: the HELIUS study

    Agyemang, Charles; Kieft, Suzanne; Snijder, Marieke B.; Beune, Erik J.; van den Born, Bert-Jan; Brewster, Lizzy M.; Ujcic-Voortman, Joanne J.; Bindraban, Navin; van Montfrans, Gert; Peters, Ron J.; Stronks, Karien

    2015-01-01

    Hypertension is a major problem among European ethnic minority groups. We assessed the current situation of hypertension prevalence and its management among a multi-ethnic population in Amsterdam, The Netherlands. Data from the HELIUS study were used including 12,974 participants (1871 Ghanaian,

  20. Gender disparities in hypertension among different ethnic groups in Amsterdam, the Netherlands: The SUNSET study

    Agyemang, Charles; de Munter, Jeroen; van Valkengoed, Irene; van den Born, Bert-Jan; Stronks, Karien

    2008-01-01

    BACKGROUND Studies have consistently shown a lower prevalence of hypertension in women than in men. Obesity is an important risk factor for hypertension, and the rate of obesity is particularly high among ethnic minority women. It is therefore questionable whether the lower prevalence of

  1. Poor hypertension control in Greek patients with diabetes in rural areas. The VANK study in primary care.

    Skliros, E; Sotiropoulos, A; Vasibossis, A; Xipnitos, C; Chronopoulos, I; Razis, N; Merkouris, Panagiotis

    2007-01-01

    This study aimed to determine hypertension prevalence and levels of awareness, treatment and control of hypertension among diabetic patients using data from the VANK study. The sample consisted of 221 men and women (122/99) diagnosed with type 2 diabetes. Semi-structured interviews were conducted with all participants. Controlled hypertension definition was based on having a systolic blood pressure (BP) of hypertension was 194/221 (87.7%). In total, 34.1% of patients (66/194) were not aware of having hypertension. Of those who were aware of having hypertension (n = 128, 65.9%), all were treated. Among those treated, only 11 persons (11/194, 5.6%) had systolic BP hypertensive patients (n = 128) received antihypertensive drug therapy, in only 8.6% (11/128) the treatment was effective (BP hypertension from primary care physicians, as well as regular surveillance to detect developing hypertension in diabetic patients.

  2. Altered vasoactive balance in hypertension: A pharmacogenomic study

    Zicha, Josef

    2006-01-01

    Roč. 24, č. S6 (2006), s. 24-24 ISSN 0263-6352. [Scientific Meeting of the International Society of Hypertension /21./. 15.10.2006-19.10.2006, Fukuoka] R&D Projects: GA MZd(CZ) NR7786 Institutional research plan: CEZ:AV0Z50110509 Keywords : vasoactive balance * hypertension * recombinant inbred strains Subject RIV: FA - Cardiovascular Diseases incl. Cardiotharic Surgery

  3. Prevalence of Hypertension in Akwa Ibom State, South-South Nigeria: Rural versus Urban Communities Study

    Effiong Ekong Akpan

    2015-01-01

    Full Text Available Recent studies have shown an increasing trend in the prevalence of hypertension in rural communities compared to that of the urban communities. This study was therefore carried out to determine the prevalence of hypertension and its predictors (if any in both urban and rural communities of Akwa Ibom State of Nigeria. Subjects and Method. This was a cross-sectional study of urban and rural communities of Akwa Ibom State for the prevalence of hypertension and its predictors. Two urban cities and two rural communities were randomly selected from the three senatorial districts of the state. Hypertension was defined based on the Seventh Report of the Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of Hypertension. Results. Nine hundred and seventy-eight (978 participants were recruited from rural areas and five hundred and ninety (590 from urban centers. The rural populace had higher systolic, diastolic, and mean arterial blood pressure than the urban populace (P<0.001, < 0.002, < 0.001, resp.. The prevalence of hypertension was significantly higher in the rural populace than in the urban populace [44.3% (95% CI 41.1–47.4% versus 28.6% (95% CI 24.9–32.3%]. Age, BMI, and proteinuria were independent predictors of hypertension occurrence. Conclusion. There is an epidemiologic change in the prevalence of hypertension in the rural communities of Nigeria.

  4. Vegetarian diet reduces the risk of hypertension independent of abdominal obesity and inflammation: a prospective study.

    Chuang, Shao-Yuan; Chiu, Tina H T; Lee, Chun-Yi; Liu, Ting-Ting; Tsao, Chwen Keng; Hsiung, Chao A; Chiu, Yen-Feng

    2016-11-01

    A vegetarian diet may prevent elevation of blood pressures and lower the risk for hypertension through lower degrees of obesity, inflammation, and insulin resistance. This study investigated the association between a vegetarian diet and hypertension incidence in a cohort of Taiwanese adult nonsmokers and examined whether this association was mediated through inflammation, abdominal obesity, or insulin resistance (using fasting glucose as a proxy). This matched cohort study was from the 1994-2008 MJ Health Screening Database. Each vegetarian was matched with five nonvegetarians by age, sex, and study site. The analysis included 4109 nonsmokers (3423 nonvegetarians and 686 vegetarians), followed for a median of 1.61 years. The outcome includes hypertension incidence, as well as SBP and DBP levels. Regression analysis was performed to assess the association between vegetarian diet and hypertension incidence or future blood pressure levels in the presence/absence of potential mediators. Vegetarians had a 34% lower risk for hypertension, adjusting for age and sex (odds ratio: 0.66, 95% confidence interval: 0.50-0.87; SBP: -3.3 mmHg, P vegetarian diet and hypertension appeared to be consistent across age groups. Taiwanese vegetarians had lower incidence of hypertension than nonvegetarians. Vegetarian diets may protect against hypertension beyond lower abdominal obesity, inflammation, and insulin resistance.

  5. Remote Monitoring of Hypertension Diseases in Pregnancy: A Pilot Study.

    Lanssens, Dorien; Vandenberk, Thijs; Smeets, Christophe Jp; De Cannière, Hélène; Molenberghs, Geert; Van Moerbeke, Anne; van den Hoogen, Anne; Robijns, Tiziana; Vonck, Sharona; Staelens, Anneleen; Storms, Valerie; Thijs, Inge M; Grieten, Lars; Gyselaers, Wilfried

    2017-03-09

    Although remote monitoring (RM) has proven its added value in various health care domains, little is known about the remote follow-up of pregnant women diagnosed with a gestational hypertensive disorders (GHD). The aim of this study was to evaluate the added value of a remote follow-up program for pregnant women diagnosed with GHD. A 1-year retrospective study was performed in the outpatient clinic of a 2nd level prenatal center where pregnant women with GHD received RM or conventional care (CC). Primary study endpoints include number of prenatal visits and admissions to the prenatal observation ward. Secondary outcomes include gestational outcome, mode of delivery, neonatal outcome, and admission to neonatal intensive care (NIC). Differences in continuous and categorical variables in maternal demographics and characteristics were tested using Unpaired Student's two sampled t test or Mann-Whitney U test and the chi-square test. Both a univariate and multivariate analysis were performed for analyzing prenatal follow-up and gestational outcomes. All statistical analyses were done at nominal level, Cronbach alpha=.05. Of the 166 patients diagnosed with GHD, 53 received RM and 113 CC. After excluding 5 patients in the RM group and 15 in the CC group because of the missing data, 48 patients in RM group and 98 in CC group were taken into final analysis. The RM group had more women diagnosed with gestational hypertension, but less with preeclampsia when compared with CC (81.25% vs 42.86% and 14.58% vs 43.87%). Compared with CC, univariate analysis in RM showed less induction, more spontaneous labors, and less maternal and neonatal hospitalizations (48.98% vs 25.00%; 31.63% vs 60.42%; 74.49% vs 56.25%; and 27.55% vs 10.42%). This was also true in multivariate analysis, except for hospitalizations. An RM follow-up of women with GHD is a promising tool in the prenatal care. It opens the perspectives to reverse the current evolution of antenatal interventions leading to more

  6. Association of overtime work and hypertension in a Japanese working population: a cross-sectional study.

    Imai, Teppei; Kuwahara, Keisuke; Nishihara, Akiko; Nakagawa, Tohru; Yamamoto, Shuichiro; Honda, Toru; Miyamoto, Toshiaki; Kochi, Takeshi; Eguchi, Masafumi; Uehara, Akihiko; Kuroda, Reiko; Omoto, Daisuke; Nagata, Tomohisa; Pham, Ngoc Minh; Kurotani, Kayo; Nanri, Akiko; Akter, Shamima; Kabe, Isamu; Mizoue, Tetsuya; Sone, Tomofumi; Dohi, Seitaro

    2014-12-01

    Long working hours have been associated with an increased risk of cardiovascular disease, but its relationship with hypertension remains unclear. The objective of this study is to examine the relationship between overtime and presence of hypertension using data from a large-scale multi-company study in Japan. Participants were 52 365 workers of four companies that provided both health-checkup data and self-reported data on overtime worked. Hypertension was defined as systolic blood pressure ≥140 mmHg, diastolic blood pressure ≥90 mmHg, and/or the use of antihypertensive drug. Logistic regression analysis was performed to determine the odds ratio for hypertension for each category of overtime work (work: 17.5, 12.0, 11.1 and 9.1% for the shortest (work and presence of hypertension.

  7. EXPERIENCE OF BARRIERS TO HYPERTENSION MANAGEMENT IN MINANGKABAU ETHNIC GROUP IN PAYAKUMBUH INDONESIA: A PHENOMENOLOGICAL STUDY

    Vera Kurnia

    2018-05-01

    Full Text Available Background: Understanding barriers to hypertension managements remains important to reduce the hypertension rate in community. Minangkabau is one of the ethnic groups in West Sumatra Indonesia that has a high proportion of people with hypertension although its management has been implemented. Objective: This study aims to explore the experiences of barriers to hypertension management in Minangkabau ethnic group in Payakumbuh, Indonesia. Methods: This was a phenomenological study with twelve respondents selected using purposive sampling. Data were collected using in-depth interview. Colaizzi’s content analysis method was used for data analysis. Results: Five themes were emerged from the data, namely: (i lack of self-motivation in the management of hypertension, (ii disobedience in the management of hypertension, (iii culture pattern of food intake, (iv lack of social support, and (v excessive stress and anxiety. Conclusions: The barriers to hypertension management in Minangkabau ethnic group are closely related to its culture both in lifestyle and in food intake of the family members and the community. Nurses are expected toalways give health education about hypertension and finding the way to control it.

  8. Joint Effects of Physical Activity and BMI on Risk of Hypertension in Women: A Longitudinal Study

    Caroline Jackson

    2014-01-01

    Full Text Available Introduction. There is debate as to whether physical activity counteracts the adverse effect of weight on health outcomes. We investigated how physical activity modifies the effect of body mass index (BMI on hypertension risk. Methods. BMI, physical activity, and hypertension were measured at baseline and at three-year interval for 14 years (from 1996 to 2010, in 10,339 participants in the Australian Longitudinal Study on Women’s Health. Generalised estimating equation models for binary repeated measures were performed to determine the individual and joint effects of BMI and physical activity on incident hypertension. Results. At baseline (mean age 47.6±1.5 SD, 57% were healthy weight, 28% overweight, and 14% obese. Increasing BMI and decreasing physical activity were associated with increased risk of hypertension. Physical activity attenuated the positive association between weight and risk of hypertension, especially for obese women. Compared to healthy weight high active women, risk of hypertension in obese high active women was 3.4 times greater (OR 3.43, 95% CI 2.68, 4.39 and in obese inactive women 4.9 times greater (OR 4.91, 95% CI 3.92, 6.13. Conclusions. Both physical activity and maintenance of a healthy body weight are associated with lower risk of hypertension. Physical activity reduced but did not remove the effect of obesity on hypertension risk.

  9. Study on predictors of health outcome in patients attending hypertension intervention programme in Malaysia.

    Wahab, Rasidah Abd.

    2008-01-01

    The aim of this study is to explore predictor of health outcomes among Malaysian hypertensive patients attending a standard hypertension intervention programme. Among the psychological predictors studied are illness perception, health locus of control, and self-efficacy. Quality of life, anxiety and depression and demographic variables are among the predictors included in the study. Two series of studies were conducted to answer the research question formulated for each study. Study 1 aims to...

  10. Leptin, not adiponectin, predicts hypertension in the Copenhagen City Heart Study

    Asferg, Camilla Lundegaard; Møgelvang, Rasmus; Flyvbjerg, Allan

    2010-01-01

    of hypertension have been directly compared. The objective of this study was to investigate the relationships between plasma levels of leptin and adiponectin and new-onset hypertension in the Copenhagen City Heart Study (CCHS). METHODS: In a prospective study design, we examined new-onset hypertension in 620...... blood pressure (DBP) > or = 90 mm Hg, or use of antihypertensive medication. Using logistic regression analysis, adjusting for age, sex, estimated glomerular filtration rate, triglycerides, high-density lipoprotein cholesterol (HDL-C), fibrinogen, and glucose, and with leptin and adiponectin included...

  11. A haemodynamic study of pulmonary hypertension in chronic hypersensitivity pneumonitis.

    Oliveira, Rudolf K F; Pereira, Carlos A C; Ramos, Roberta P; Ferreira, Eloara V M; Messina, Carolina M S; Kuranishi, Lilian T; Gimenez, Andrea; Campos, Orlando; Silva, Célia M C; Ota-Arakaki, Jaquelina S

    2014-08-01

    Chronic hypersensitivity pneumonitis is a common fibrotic interstitial lung disease. The prevalence of pulmonary hypertension diagnosed by right heart catheterisation and its cardiopulmonary function findings in patients with chronic hypersensitivity pneumonitis are unknown. Consecutive symptomatic patients with chronic hypersensitivity pneumonitis were prospectively evaluated. All patients were submitted to right heart catheterisation, pulmonary function testing, a 6-min walk test, echocardiography, blood gas determination and N-terminal pro-brain natriuretic peptide analyses. Nonhypoxaemic patients also underwent incremental cardiopulmonary exercise testing. 50 patients underwent right heart catheterisation; 25 (50%) of these had pulmonary hypertension and 22 (44%) had a pre-capillary haemodynamic pattern. The patients with pre-capillary pulmonary hypertension had lower forced vital capacity (mean ± sd 50 ± 17% versus 69 ± 22% predicted, p<0.01), carbon monoxide diffusing capacity (37 ± 12% versus 47 ± 14% predicted, p<0.01), arterial oxygen tension (median (interquartile range) 59.0 (47.8-69.3) versus 73.0 (62.2-78.5) mmHg, p<0.01) and saturation after the 6-min walk test (78 ± 8% versus 86 ± 7%, p<0.01). In pre-capillary pulmonary hypertension, oxygen uptake was also lower at the anaerobic threshold (41 ± 11% versus 50 ± 8% predicted, p=0.04) and at peak exercise (12.8 ± 1.6 versus 15.0 ± 2.5 mL · kg(-1) · min(-1), p=0.02). Pre-capillary pulmonary hypertension is common in symptomatic chronic hypersensitivity pneumonitis and is related to interstitial lung disease severity. Additionally, pulmonary hypertension is more prevalent in hypoxaemic patients with impaired lung function and exercise capacity. ©ERS 2014.

  12. Hypertension, risk factors and coronary artery stenosis: A case-control study.

    Sedaghat, Zahra; Zibaeenejad, Mohammadjavad; Fararouei, Mohammad

    2018-04-25

    Although hypertension is introduced as a major risk factor for cardiovascular diseases (CVDs), our knowledge about the nature of the association is hindered. The aim of this study was to assess the concurrent associations of several factors including serologic, anthropometric and coronary artery stenosis (CAS) with blood pressure. This is a case-control study on 163 hypertensive patients (SBP > 140 mmHg or DBP > 80 mmHg) and 227 healthy participants. All participants underwent angiography due to classic symptoms of CVDs. Controlling for other study variables, significant associations between CAS (OR yes/no = 1.99, 95%CI: 1.18-3.34 P = 0.006), BMI (kg/m 2 ) (OR = 1.08, 95%CI: 1.03-1.14, P = 0.002) and age (year) (OR = 1.03, 95%CI = 1.005-1.05, p = 0.01) with hypertension were found. However, according to the results of the stratified analysis, no such associations were found among those with significant CAS. BMI and age were the only significant predictors of hypertension among participants with no CAS. Abdominal obesity was not remained in the final model regardless of the presence or absence of stenosis. As expected, stenosis itself was significantly associated with hypertension. This study suggested that BMI and age are the most powerful predictors of hypertension among those without CAS. As the result, it can be concluded that CAS alters the association between several factors and hypertension.

  13. Hypertension Subtypes among Hypertensive Patients in Ibadan

    Abiodun M. Adeoye

    2014-01-01

    Full Text Available Background. Certain hypertension subtypes have been shown to increase the risk for cardiovascular morbidity and mortality and may be related to specific underlying genetic determinants. Inappropriate characterization of subtypes of hypertension makes efforts at elucidating the genetic contributions to the etiology of hypertension largely vapid. We report the hypertension subtypes among patients with hypertension from South-Western Nigeria. Methods. A total of 1858 subjects comprising 76% female, hypertensive, aged 18 and above were recruited into the study from two centers in Ibadan, Nigeria. Hypertension was identified using JNCVII definition and was further grouped into four subtypes: controlled hypertension (CH, isolated systolic hypertension (ISH, isolated diastolic hypertension (IDH, and systolic-diastolic hypertension (SDH. Results. Systolic-diastolic hypertension was the most prevalent. Whereas SDH (77.6% versus 73.5% and IDH (4.9% versus 4.7% were more prevalent among females, ISH (10.1% versus 6.2% was higher among males (P=0.048. Female subjects were more obese (P<0.0001 and SDH was prevalent among the obese group. Conclusion. Gender and obesity significantly influenced the distribution of the hypertension subtypes. Characterization of hypertension by subtypes in genetic association studies could lead to identification of previously unknown genetic variants involved in the etiology of hypertension. Large-scale studies among various ethnic groups may be needed to confirm these observations.

  14. Karşıyaka Prevalance and Awareness of Hypertension Study (KARHIP

    Nihat Pekel

    2016-01-01

    Conclusions: Hypertension prevalances in our study were similar to the PatenT 2 trial prevalances, which were 46 % for the middle age group and 78% for the geriatric age group. Compared to PatenT 2 data, the rate of hypertension awareness (54.7% vs 72.3% and the rate of being under treatment (47.5% vs 69.4% were higher. The rate of controlled hypertension was a little bit higher (28.7 % vs 34.7% in our group, whereas control rates in aware and treated groups were similar (53.9 % and 50.1 % in both studies.

  15. Literacy and motivation for the prevention and control of hypertension among female community health volunteers: a qualitative study from Nepal

    Dinesh Neupane

    2015-12-01

    Full Text Available Background: The prevalence of hypertension is increasing in Nepal. Thus, there is a need for a programme to improve primary healthcare. One possibility is to assign prevention, diagnosis, and treatment of hypertension to female community health volunteers (FCHVs. Objective: To assess literacy and motivation to be involved in a hypertension prevention and control programme in Nepal among FCHVs. Design: Five focus group discussions (FGDs were conducted with a total of 69 FCHVs in Lekhnath municipality, Kaski district, Nepal. Seven themes were developed on the basis of data collection: 1 knowledge about hypertension; 2 risk factors of hypertension; 3 prevention and control of hypertension; 4 access to treatment for hypertension in the community; 5 learning about blood pressure measurement; 6 ability to raise blood pressure awareness in the community; 7 possible challenges for their future involvement. Data were analysed using the thematic analysis approach. Results: FCHVs have some knowledge about diagnosis, risk factors, and complications of hypertension. General unanimity was observed in the understanding that hypertension and risk factors needed to be addressed. The willingness of FCHVs to contribute to prevention, control, and management was strong, and they were confident that with some basic training they could obtain skills in hypertension management. Conclusions: Despite limited knowledge about hypertension, FCHVs expressed willingness and readiness to be trained in hypertension management. This study supports the possibility of involving FCHVs in prevention and control of hypertension in Nepal.

  16. Cardiovascular reactivity in young adults with hypertensive and normotensive parents: A gender based comparative study

    Anjali Verma

    2017-01-01

    Full Text Available Introduction: Essential hypertension begins due to mutation of specific genes that contribute to the risk of developing hypertension. Genetic contribution was recognized 25 years ago, now formulated from time to time. Some studies have also proven that the hypertension in father had strong contribution in their individual than mother. The aim of the study is to compare the cardiovascular reactivity in male and female subjects with hypertensive and normotensive parents. Materials and methods: This comparative study was conducted in physiology department of Teerthanker Mahaveer medical college and research center, Moradabad. The research work was initiated after taken the ethical clearance from the ethical committee of the college. Three different stressors: cold pressor task, cycling and videogame were used. Total 120 subjects were taken for the study in which 77 were male and 43 were female. Result: Male subjects of normotensive parents had slightly higher HR rate (mean: 76.73/min compared to the female subjects (mean: 75/min with p value >0.05. Female subjects of hypertensive parents had higher HR rate (mean: 82.72/min compared to the male subjects (mean: 73.95/min with p value <0.001. Conclusion: Male subjects with normotensive parents had higher resting HR, SBP &DBP than Female subjects with normotensive parents, but the difference was significant only in SBP. Female subjects with hypertensive parents group was showing higher resting HR than male subjects with hypertensive parents group, remains higher after stress also with insignificant difference. Thus, subjects with hypertensive parents showing increased CVR to stress are more likely to develop future hypertension, and the risk is greater for male subjects.

  17. TELMISARTAN IN THE TREATMENT OF ARTERIAL HYPERTENSION. CASE STUDY

    V. I. Podzolkov

    2015-12-01

    Full Text Available Data on angiotensin II receptor blockers, one of the main drug classes used in cardiology , are presented. The advantages of this drugs class are highlighted with the focus on telmisartan. Additionally clinical example of successful telmisartan application in patients with hypertension, high risk of cardiovascular complications, and obesity is presented.

  18. TELMISARTAN IN THE TREATMENT OF ARTERIAL HYPERTENSION. CASE STUDY

    V. I. Podzolkov

    2012-01-01

    Full Text Available Data on angiotensin II receptor blockers, one of the main drug classes used in cardiology , are presented. The advantages of this drugs class are highlighted with the focus on telmisartan. Additionally clinical example of successful telmisartan application in patients with hypertension, high risk of cardiovascular complications, and obesity is presented.

  19. [Microalbuminuria in diabetic and hypertensive patients: a study of 979 patients].

    Roberto Robles, Nicolás; Velasco, Joaquín; Mena, Cándido; Angulo, Enrique; Garrote, Timotea

    2006-11-25

    Microalbuminuria is a known complication of diabetes mellitus but it is also a cardiovascular risk factor commonly present among hypertensive (non diabetic) population. The prevalence of microalbuminuria is variable and it has been never estimated in our region. The aim of this study has been to determine the prevalence of microalbuminuria in hypertensive (non diabetic) and diabetic population in Extremadura (Spain). The study included diabetic patients and non-diabetic hypertensive ones randomly selected. Microalbuminuria was measured in every patient using albumin/creatinin reactive stick in fasting first morning urine. Whenever possible microalbuminuria was confirmed in laboratory by microalbuminuria/creatinina coefficient in first morning urine samples. A total of 979 patients (mean age [SD], 67.9 [10.8] years; 409 men and 570 women, 505 diabetics) were studied. The presence of microalbuminuria was found in 12.4% of hypertensive patients and in 21.4% of diabetic patients (p < 0.001). Hypertensives and normotensive diabetics showed a similar prevalence of microalbuminuria (13.3%, not significant), but it tripled in hypertensive diabetics (33.8; p < 0.01). Glicemic control was not different for microalbuminuric diabetic patients and non microalbuminuric ones. The patients receiving rennin-angiotensin axis blocking drugs do not showed less prevalence of microalbuminuria (hypertensives 10.5%, diabetics 23.5%). Microalbuminuria was confirmed in 65.4% of patients. The prevalence of microalbuminuria in Extremadura seems to be high either in diabetics or non diabetic hypertensive patients. The finding of microalbuminuria in diabetics patients correlates with hypertension but do not with glicemic control. The prevalence of microalbuminuria is high in spite of using rennin-angiotensin axis blocking drugs.

  20. Breakfast cereals and risk of hypertension in the Physicians' Health Study I.

    Kochar, Jinesh; Gaziano, J Michael; Djoussé, Luc

    2012-02-01

    Hypertension is a major public health problem. While many dietary factors affect the risk of developing hypertension, limited data are available on the association between consumption of breakfast cereal and incident hypertension. We examined the association between breakfast cereal consumption and the risk of hypertension. We prospectively analyzed data from 13,368 male participants of the Physicians' Health Study I. Consumption of breakfast cereals was estimated using an abbreviated food frequency questionnaire and incident hypertension was ascertained through yearly follow-up questionnaires. The average age of study participants was 52.4 ± 8.9 years (range 39.7-85.9) during the initial assessment of cereal intake (1981-1983). During a mean follow up of 16.3 years, 7267 cases of hypertension occurred. The crude incidence rates of hypertension were 36.7, 34.0, 31.7, and 29.6 cases/1000 person-years for people reporting breakfast cereal intake of 0, ≤1, 2-6, and ≥7 servings/week, respectively. In a Cox regression model adjusting for age, smoking, body mass index, alcohol consumption, fruit and vegetable consumption, physical activity, and history of diabetes mellitus, hazard ratios (95% CI) for hypertension were 1.0 (reference), 0.93 (0.88-0.99), 0.88 (0.83-0.94), and 0.81 (0.75-0.86) from the lowest to the highest category of cereal consumption, respectively (p for trend cereals and was observed in lean as well as overweight or obese participants. The results of this longitudinal cohort study suggest that whole grain breakfast cereal consumption confers a lower risk of hypertension in middle-aged adult males. Copyright © 2011 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  1. Breakfast cereals and risk of hypertension in the Physicians’ Health Study I

    Kochar, Jinesh; Gaziano, J. Michael; Djoussé, Luc

    2012-01-01

    Summary Background and aims Hypertension is a major public health problem. While many dietary factors affect the risk of developing hypertension, limited data are available on the association between consumption of breakfast cereal and incident hypertension. We examined the association between breakfast cereal consumption and the risk of hypertension. Methods We prospectively analyzed data from 13,368 male participants of the Physicians’ Health Study I. Consumption of breakfast cereals was estimated using an abbreviated food frequency questionnaire and incident hypertension was ascertained through yearly follow-up questionnaires. Results The average age of study participants was 52.4 ±8.9 years (range 39.7-85.9) during the initial assessment of cereal intake (1981-1983). During a mean follow up of 16.3 years, 7,267 cases of hypertension occurred. The crude incidence rates of hypertension were 36.7, 34.0, 31.7, and 29.6 cases/1,000 person-years for people reporting breakfast cereal intake of 0, ≤ 1, 2-6, and ≥ 7 servings/week, respectively. In a Cox regression model adjusting for age, smoking, body mass index, alcohol consumption, fruit and vegetable consumption, physical activity, and history of diabetes mellitus, hazard ratios (95% CI) for hypertension were 1.0 (reference), 0.93 (0.88-0.99), 0.88 (0.83-0.94), and 0.81 (0.75-0.86) from the lowest to the highest category of cereal consumption, respectively (p for trend cereals and was observed in lean as well as overweight or obese participants. Conclusions The results of this longitudinal cohort study suggest that whole grain breakfast cereal consumption confers a lower risk of hypertension in middle-aged adult males PMID:21868140

  2. Perceptions on hypertension among migrants in Delhi, India: a qualitative study

    Kusuma Yadlapalli S

    2009-07-01

    Full Text Available Abstract Background The developing countries are experiencing epidemiological transition and hypertension has emerged as a major threat to health in these countries. Understanding people's perceptions is important for any prevention and control activities and lay explanatory models (EMs provide an opportunity to gain insights into the people's perceptions. This qualitative study is taken up with an objective of understanding EMs of neo- and settled-migrants regarding hypertension. Methods Qualitative methods with grounded theory approach were used to elicit EMs of hypertension held by neo- and settled-migrants. In-depth interviews with key-informants and focus group discussions with community members were conducted. The data were subjected to thorough reading and analysed by segregating the text under different themes. Results Hypertension has been perceived as a common and serious problem in the community. Lay conceptions have identified hypertension as symptomatic with ambiguity over perceived symptoms. City life has been perceived as a major predisposing factor for developing hypertension. City life has been corroborated with pollution and adulteration of food, stress, high fat diet along with physical inactivity and certain attitudes. The concepts of hypertension were interconnected and linked to their day-to-day living in the city. Inadequacy of awareness has been acknowledged and there was a felt need for awareness campaigns and screening programmes in the community. The EMs of hypertension among the neo- and settled-migrants and men and women were broadly similar. However, there were slight variations by gender and migration status in the perceived pathways to hypertension. Conclusion Hypertension has been perceived as a common and serious problem in the community. Hypertension has been perceived as symptomatic; however, ambiguity prevails over perceived symptoms. Awareness and knowledge about hypertension and its consequences are

  3. A Propensity-Matched Study of Hypertension and Increased Stroke-Related Hospitalization in Chronic Heart Failure

    G.S. Filippatos (Gerasimos); C. Adamopoulos (Chris); X. Sui (Xuemei); T.E. Love (Thomas); P.M. Pullicino (Patrick); J. Lubsen (Jacob); G. Bakris (George); S.D. Anker (Stefan); G. Howard (George); D.T. Kremastinos (Dimitrios); A. Ahmed (Ali)

    2008-01-01

    textabstractHypertension is a risk factor for heart failure and stroke. However, the effect of hypertension on stroke in patients with heart failure has not been well studied. In the Digitalis Investigation Group trial, 3,674 (47%) of the 7,788 patients had a history of hypertension. Probability or

  4. Kidney Measures with Diabetes and Hypertension on Cardiovascular Disease : The Atherosclerosis Risk in Communities Study

    Alexander, Nadine; Matsushita, Kunihiro; Sang, Yingying; Ballew, Shoshana; Mahmoodi, Bakhtawar K.; Astor, Brad C.; Coresh, Josef

    2015-01-01

    Background: Whether the association of chronic kidney disease (CKD) with cardiovascular risk differs based on diabetes mellitus (DM) and hypertension (HTN) status remains unanswered. Methods: We investigated 11,050 participants from the Atherosclerosis Risk in Communities Study (fourth examination

  5. Study of drug–Drug interactions among the hypertensive patients in a tertiary care teaching hospital

    Ansha Subramanian

    2018-01-01

    Conclusion: The study highlighted that patients with hypertension are particularly vulnerable to DDI. The comorbidities, advanced age, and polypharmacy are the important factors associated with the occurrence of DDI.

  6. Conjoint Associations of Gestational Diabetes and Hypertension With Diabetes, Hypertension, and Cardiovascular Disease in Parents: A Retrospective Cohort Study.

    Pace, Romina; Brazeau, Anne-Sophie; Meltzer, Sara; Rahme, Elham; Dasgupta, Kaberi

    2017-11-15

    The conjoint association of gestational diabetes mellitus (GDM) and gestational hypertension (GH) with cardiometabolic disease has not been well studied. We evaluated a combined GDM/GH risk indicator in both mothers and fathers because of shared spousal behaviors and environments. In the present population-based retrospective cohort study, GH was identified in matched pairs of mothers with GDM or without GDM (matched on age group, health region, and year of delivery) who had singleton live births in Quebec, Canada (1990-2007). A total of 64,232 couples were categorized based on GDM/GH status (neither, either, or both). Associations with diabetes, hypertension, and a composite of cardiovascular disease (CVD) and mortality were evaluated using Cox proportional hazard models (from 12 weeks postpartum to March 2012). Compared with having neither GDM nor GH, having either was associated with incident diabetes (hazard ratio (HR) = 14.7, 95% confidence interval (CI): 12.9, 16.6), hypertension (HR = 1.9, 95% CI: 1.8, 2.0), and CVD/mortality (HR = 1.4, 95% CI: 1.2, 1.7). We found associations of greater magnitude among participants who had both (for diabetes, HR = 36.9, 95% CI: 26.0, 52.3; for hypertension, HR = 5.7, 95% CI: 4.9, 6.7; and for CVD/mortality, HR = 2.4, 95% CI: 1.6, 3.5). Associations with diabetes were also observed in fathers (for either, HR = 1.2, 95% CI: 1.1, 1.3; for both, HR = 1.8, 95% CI: 1.4, 2.3). In conclusion, we found associations of a combined GDM/GH indicator with cardiometabolic disease in mothers and with diabetes in fathers, with stronger associations when both GDM and GH were present. © The Author(s) 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health.

  7. Body Mass Index, Smoking and Hypertensive Disorders during Pregnancy: A Population Based Case-Control Study.

    Thuridur A Gudnadóttir

    Full Text Available While obesity is an indicated risk factor for hypertensive disorders of pregnancy, smoking during pregnancy has been shown to be inversely associated with the development of preeclampsia and gestational hypertension. The purpose of this study was to investigate the combined effects of high body mass index and smoking on hypertensive disorders during pregnancy. This was a case-control study based on national registers, nested within all pregnancies in Iceland 1989-2004, resulting in birth at the Landspitali University Hospital. Cases (n = 500 were matched 1:2 with women without a hypertensive diagnosis who gave birth in the same year. Body mass index (kg/m2 was based on height and weight at 10-15 weeks of pregnancy. We used logistic regression models to calculate odds ratios and corresponding 95% confidence intervals as measures of association, adjusting for potential confounders and tested for additive and multiplicative interactions of body mass index and smoking. Women's body mass index during early pregnancy was positively associated with each hypertensive outcome. Compared with normal weight women, the multivariable adjusted odds ratio for any hypertensive disorder was 1.8 (95% confidence interval, 1.3-2.3 for overweight women and 3.1 (95% confidence interval, 2.2-4.3 for obese women. The odds ratio for any hypertensive disorder with obesity was 3.9 (95% confidence interval 1.8-8.6 among smokers and 3.0 (95% confidence interval 2.1-4.3 among non-smokers. The effect estimates for hypertensive disorders with high body mass index appeared more pronounced among smokers than non-smokers, although the observed difference was not statistically significant. Our findings may help elucidate the complicated interplay of these lifestyle-related factors with the hypertensive disorders during pregnancy.

  8. Cardiovascular morbidity of severe resistant hypertension among treated uncontrolled hypertensives: a 4-year follow-up study.

    Kasiakogias, Alexandros; Tsioufis, Costas; Dimitriadis, Kyriakos; Konstantinidis, Dimitrios; Koumelli, Areti; Leontsinis, Ioannis; Andrikou, Eirini; Vogiatzakis, Nikos; Marinaki, Smaragdi; Petras, Dimitrios; Fragoulis, Christos; Konstantinou, Konstantinos; Papademetriou, Vasilios; Tousoulis, Dimitrios

    2018-05-01

    Data regarding the prognosis of resistant hypertension (RHTN) with respect to its severity is limited. We investigated the cardiovascular risk of severe RHTN in a prospective observational study. A cohort of 1700 hypertensive patient with treated uncontrolled HTN was followed for a mean period of 3.6 ± 1.8 years. At baseline, standard clinical and laboratory workup was performed, including testing for secondary causes of RHT where applicable. Three groups were identified depending on presence of RHTN (office-based uncontrolled HTN under at least three drugs including a diuretic) and levels of office systolic blood pressure (BP): 1187 patients (70%) without RHTN, 313 (18%) with not-severe RHTN (systolic BP < 160 mmHg) and 200 (12%) with severe RHTN (systolic BP ≥ 160 mmHg). Endpoint of interest was cardiovascular morbidity set as the composite of coronary heart disease and stroke. During follow-up, incidence rates of cardiovascular events per 1000 person-years were 7.1 cases in the non-RHTN group, 12.4 cases in the not-severe RHTN group and 18 cases in the severe RHTN group. Unadjusted analysis showed that compared to uncontrolled patients without RHTN, patients with not-severe RHTN exhibited a similar risk but patients with severe RHTN had a significantly higher risk, by 2.5 times (CI: 1.28-4.73, p = 0.007). Even after multivariate adjustment for established risk factors including BP levels and isolated systolic HTN, severe RHTN remained as an independent predictor of the cardiovascular outcome (OR: 2.30, CI: 1.00-5.29, p = 0.05). In conclusion, among treated yet uncontrolled hypertensive patients, severe RHTN exhibits a significantly higher cardiovascular risk indicating the need for prompt management.

  9. Causes of secondary hypertension in the young population: A monocentric study.

    Noilhan, C; Barigou, M; Bieler, L; Amar, J; Chamontin, B; Bouhanick, B

    2016-06-01

    To study the prevalence of different causes of hypertension in young adults referred to a hypertension center in the south west of France. We conducted a retrospective overview of patients younger than 40years old hospitalized consecutively in the Hypertension department of Toulouse University Hospital between 2012 and 2014. Clinical data about gender, age, anthropomorphic parameters and blood pressure measurement by 24h Ambulatory Blood Pressure Monitoring (ABPM) were recorded. Biological data concerned dosages of kalemia, renin and aldosterone in the supine or after 15min of seating. Recorded radiological examinations were renal artery ultrasound and abdominal CT scan. One hundred and forty-eight detailed medical records were analyzed, 69 women and 79 men. Among the 69 women, the causes of secondary hypertension were primary aldosteronism (n=7), fibromuscular dysplasia (n=5) and renal disease (n=4). Oral contraceptives were involved in 13 women. In addition, essential hypertension concerned 40 women (58%). Among the 79 men, the causes of secondary hypertension were primary aldosteronism (n=10), fibromuscular dysplasia (n=3), left main renal artery entrapment by a diaphragmatic crura (n=2), renal disease (n=1), pheochromocytoma (n=3) and coarctation of the aorta (n=2). In addition, essential hypertension concerned 58 men (73%). In our population, the prevalence of secondary hypertension is close to 33% (42% of females and 27% of males), with the following main causes: primary aldosteronism for 11.5%; fibromuscular dysplasia for 5.4%. Oral contraceptives were involved in the hypertension of 19% of the females. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  10. Plasma ET-1 Concentrations are Elevated in Patients with Hypertension - Meta-Analysis of Clinical Studies.

    Xu, Mei; Lu, Yong-Ping; Hasan, Ahmed Abdallah; Hocher, Berthold

    2017-01-01

    A recent study revealed that global overexpression of ET-1 causes a slight reduction in systemic blood pressure. Moreover, heterozygous ET-1 knockout mice are hypertensive. The role of ET-1 in human hypertension was so far not addressed by a strict meta-analysis of published human clinical studies. We included studies published between January 1, 1990 and February 28, 2017. We included case control studies analyzing untreated essential hypertension or hypertensive patients where antihypertensive medication was discontinued for at least two weeks. Based on the principle of Cochrane systematic reviews, case control studies (CCSs) in PubMed (Medline) and Google Scholar designed to identify the role of endothelin-1 (ET-1) in the pathophysiological of hypertension were screened. Review Manager Version 5.0 (Rev-Man 5.0) was applied for statistical analysis. Mean difference and 95% confidence interval (CI) were shown in inverse variance (IV) fixed-effects model or IV random-effects models. Eleven studies fulfilling our in- and exclusion criteria were eligible for this meta-analysis. These studies included 450 hypertensive patients and 328 controls. Our meta-analysis revealed that ET-1 plasma concentrations were higher in hypertensive patients as compared to the control patients [mean difference between groups 1.57 pg/mL, 95%CI [0.47∼2.68, P = 0.005]. These finding were driven by patients having systolic blood pressure higher than 160 mmHg and diastolic blood pressure higher than 100 mmHg. This meta-analysis showed that hypertensive patients do have elevated plasma ET-1 concentrations. This finding is driven by those patients with high systolic/diastolic blood pressure. Given that the ET-1 gene did not appear in any of the whole genome association studies searching for hypertension associated gene loci, it is very likely that the elevated plasma ET-1 concentrations in hypertensive patients are secondary to hypertension and may reflect endothelial cell damage. © 2017 The

  11. Laparoscopic versus open splenectomy for portal hypertension: a systematic review of comparative studies.

    Cai, Yunqiang; Liu, Zhihong; Liu, Xubao

    2014-08-01

    Laparoscopic splenectomy has become the gold-standard procedure for normal to moderately enlarged spleens. However, the safety of laparoscopic splenectomy for patients with portal hypertension remains controversial. We carried out this systematic review to identify the feasibility and safety of laparoscopic splenectomy in treating portal hypertension. A systematic search for comparative studies that compared laparoscopic splenectomy with open splenectomy for portal hypertension was carried out. Studies were independently reviewed for quality, inclusion and exclusion criteria, demographic characteristics, and perioperative outcomes. Although laparoscopic splenectomy is associated with longer operating time, it offers advantages over the open procedure in terms of less blood loss, lower operative complications, earlier resumption of oral intake, and shorter posthospital stay. Therefore, laparoscopic splenectomy is a safe and feasible intervention for portal hypertension. © The Author(s) 2014.

  12. A Histopathological Study of Pulmonary Hypertension in Connective Tissue Disease

    Nobuhito Sasaki

    2011-01-01

    Full Text Available Connective tissue diseases (CTD, such as systemic sclerosis (SSc, systemic lupus erythematosus (SLE, and mixed connective tissue disease (MCTD, develop pulmonary hypertension (PH. Generally all PH cases associated with any CTD are classified into the same PH group. However, histological examination shows both common and specific lesions for each disease. In patients with SLE, fibrosis is generally rare and mild. The findings of PH in SLE are similar to those in primary pulmonary hypertension. Many cases of SSc are accompanied by fibrosis. MCTD is rather close to SSc. Arterial and arteriolar lesions of MCTD are characterized by fibrous intimal thickening. In this review, we describe the pathological features of PH associated with each CTD.

  13. ?I have to live like I?m old.? Young adults? perspectives on managing hypertension: a multi-center qualitative study

    Johnson, Heather M.; Warner, Ryan C.; LaMantia, Jamie N.; Bowers, Barbara J.

    2016-01-01

    Background In the U.S., young adults (18?39 year-olds) have the lowest hypertension control rates among hypertensive adults. Understanding young adults? unique perceptions about hypertension and perceived barriers to hypertension control is critical to develop effective interventions for this population. This multi-center study explored young adults?: 1) emotions and reactions after a hypertension diagnosis, 2) attitudes about managing hypertension (lifestyle changes, follow-up visits, antihy...

  14. Prevalence of hypertension and hypertension control rates among elderly adults during the cold season in rural Northeast China: a cross-sectional study.

    Kawazoe, Nobuo; Zhang, Xiumin; Chiang, Chifa; Liu, Hongjian; Li, Jinghua; Hirakawa, Yoshihisa; Aoyama, Atsuko

    2018-05-01

    Objective: The burden of noncommunicable diseases (NCDs) is increasing in China, together with economic development and social changes. The prevalence of risk factors for NCDs, such as overweight/obesity, hypertension, diabetes, and dyslipidemia, is reported to be high even among poor residents of rural areas. We aimed to investigate the prevalence of hypertension among elderly adults in rural Northeast China and the proportion with controlled hypertension among those on antihypertensive medication (hypertension control rate). We also aimed to examine the association of hypertension control with health facilities that provide treatment. Methods: We conducted a community-based cross-sectional study in six rural villages of Northeast China from February to early March, 2012. We interviewed 1593 adults aged 50-69 years and measured their blood pressure. We examined the differences in mean blood pressure between participants who obtained antihypertensive medication from village clinics and those who obtained medication from other sources, using analysis of covariance adjusted for several covariates. Results: The prevalence of hypertension among participants was as high as 63.3%, but the hypertension control rate was only 8.4%. Most villagers (98.1%) were not registered in the chronic disease treatment scheme of the public rural health insurance. The mean systolic blood pressure, adjusted for the covariates, of participants who obtained antihypertensive medication from village clinics was significantly lower than that of participants who obtained medication from township hospitals (by 16.5 mmHg) or from private pharmacies (by 7.3 mmHg). Conclusion: The prevalence of hypertension was high and the hypertension control rate low among elderly villagers during the cold season. As treatment at village clinics, which villagers can access during the cold season seems to be more effective than self-medication or treatment at distant hospitals, improving the quality of treatment

  15. Effect of shift work on hypertension: cross sectional study.

    Yeom, Jeong Han; Sim, Chang Sun; Lee, Jiho; Yun, Seok Hyeon; Park, Sang Jin; Yoo, Cheol-In; Sung, Joo Hyun

    2017-01-01

    The need of efficient resource management and full-time accessibility to resources has increased with the development of industry, resulting in the increase of shift workers. Previous researches of past decades show that there are various health effects on shift workers. However, the definition and the form of shift work have varied from each research and occupational harmful factors except for shift work have not been excluded completely in previous researches. Therefore, in this research, we tried to find out the effect of shift work focusing on the hypertension. To complement previously mentioned weakness of other researches, we performed our research on participants to whom we could minimize other risk factors excluding shift work. This research examined 1,953 petrochemical plant male workers (shift work 1,075, day worker 878) who did medical checkup from 1st Jan. 2014 to 31th Dec. 2014 in a general hospital located in Ulsan, based on their medical records and questionnaires. With the questionnaire, we found out their basic information including age, social status, occupational history, and we took their physical measurements. Compared to day workers, shift workers' odds ratio of developing hypertension was 1.31 (95% CI 0.98-1.75). After adjusting confounding variables, adjusted odds ratio for entire subjects was 1.51 (95% CI 1.11-2.06). Also, for subjects who were in continuous service for over 20 years, odds ratio was 1.51 (95% CI 1.08-2.11). Shift workers had a higher chance of hypertension than day workers do. Particularly, the longer the workers work continuously, the risk of hypertension getting higher.

  16. Shoshin beriberi-thiamine responsive pulmonary hypertension in exclusively breastfed infants: A study from northern India.

    Bhat, Javeed Iqbal; Rather, Hilal Ahmad; Ahangar, Ambreen Ali; Qureshi, Umar Amin; Dar, Parvez; Ahmed, Qazi Iqbal; Charoo, Bashir Ahmed; Ali, Syed Wajid

    To study the effect of thiamine administration on the resolution of pulmonary hypertension in exclusively breastfed infants. Prospective cohort study. Hospital based study of a tertiary care hospital. A total of 29 infants with 17 males (58.6%) and 12 females (41.4%) were included in the study. In addition to the management of shock, right heart failure and renal failure, patients received intravenous thiamine 100mg/kg IV followed by 10mg/day till introduction of supplementary feeds. Resolution of shock, metabolic complications and pulmonary hypertension. Mean age at presentation was 78.45±30.7 days. All infants were exclusively breastfed. 86.2% of mothers were on customary dietary restrictions. Biventricular failure and tachycardia was commonly present. There were four deaths in our series. Acute metabolic acidosis was a universal feature with a mean pH of 7.21±0.15. Pulmonary hypertension was present in all patients on admission. Intravenous thiamine 100mg/kg IV stat was given immediately after documenting pulmonary hypertension. Repeat echocardiography showed complete resolution of pulmonary hypertension. Many infants present to us with Shoshin beriberi with unusually high pulmonary pressures. These patients respond to thiamine challenge with prompt resolution of metabolic complications and reversal of pulmonary hypertension. We believe this is first of its kind from the region, which is reported. Copyright © 2016. Published by Elsevier B.V.

  17. A STUDY OF ELECTROCARDIOGRAPHY AND KIDNEY FUNCTION TEST IN NEWLYDIAGNOSED HYPERTENSIVE PATIENTS IN COASTAL ANDHRA PRADESH

    Ramswaroop

    2017-11-01

    Full Text Available BACKGROUND As per the fact sheet published by World Health Organisation, South East Asia, nearly one billion people have high blood pressure and are one of the most common causes of premature death worldwide. About one third of the adult population in the South East Asia region is having hypertension. In our country, the number of people with hypertension are undiagnosed and untreated, so early detection and treatment of hypertension will decrease the complication of hypertension and premature death due to it. MATERIALS AND METHODS This is a prospective study conducted in the Department of General Medicine, Konaseema Institute of Medical Sciences, Amalapuram, from May 2015 to August 2017. This study was started with an aim to know that electrocardiographic abnormalities and kidney function at the time of diagnosis of hypertension in a patient in coastal Andhra Pradesh. RESULTS We have found ECG changes in both the stages of hypertensive group patients. In stage-1 hypertensive group patients, out of 80 patients, 6 patients having sinus tachycardia, 2 having sinus bradycardia, 4 patients having left bundle-branch block and 6 having right bundle-branch block. ST elevation was found in 1 patient and ST depression was found in 8 patients. AV block was present in 2 patients. Right ventricular hypertrophy was present in 1 patient and left ventricular hypertrophy was present in 4 patients. T-wave inversion was found in 4 patients. In stage-2 hypertensive patients, sinus tachycardia in 6 patients and bradycardia in 1 patient, LBBB was found in 8 patients. ST depression was found in 6 patients and ST elevation was found in 2 patients out of 40 patients. AV block was present in 3 patients. Left ventricular hypertrophy patients 16 out of 40, but right ventricular hypertrophy was only 1. T-wave inversion was found in 6 patients. CONCLUSION In our study, we have found that stage-2 hypertensive patients have higher BMI, serum urea and creatinine than stage-1

  18. [Prevalence of hypertension in elderly long-term care residents in Spain. The Geriatric HTA study].

    Martín-Baranera, Montserrat; Sánchez Ferrín, Pau; Armario, Pedro

    2006-11-11

    This study aimed to estimate the prevalence of hypertension in elderly long-term care residents in Spain and to describe such population in terms of comorbidity and hypertension treatment and control. A countrywide cross-sectional study was conducted in May 2003 among long-term care residents aged 65 or more. Patients in palliative care units were excluded. Hypertension was defined in patients who fulfilled at least one of the following criteria: diagnosis of hypertension on the medical record, antihypertensive medication and/or highest blood pressure values during the previous year > or = 140/90 mmHg. Overall, 13,272 subjects - mean age (standard deviation) 82.9 (7.5) years (range: 65-106 years) - were included from 223 centres; 70.6% were women. Almost 2 thirds of patients met at least one hypertension criterion (8,242 patients, 62.1%; 95% confidence interval, 61.3-62.9%). In those patients, other frequent cardiovascular risk factors were obesity (26.3%), diabetes (25.7%) and dislipemia (23.8%). A concomitant diagnosis of dementia, peripheral vascular disease, stroke or congestive heart failure was present in 37.1%, 28.3%, 26.0% and 25.1%, respectively. The proportion of hypertensive patients receiving at least one antihypertensive drug was 69.7%. Diuretics were the most commonly used agents (46.3%), followed by angiotensine converting enzyme inhibitors (34.6%). The latest blood pressure measurement was < 140/90 mmHg in 60.4% of the hypertensive patients. Elderly long-term care residents in Spain showed a high prevalence of hypertension and other cardiovascular risk factors, and a substantial degree of associated clinical conditions. The proportion of antihypertensive drug therapy was comparable to those reported in similar studies.

  19. Exploratory studies of some Mexican medicinal plants. Cardiovascular effects in rats with and without hypertension.

    Gil Alfonso Magos-Guerrero

    2017-09-01

    Full Text Available Background: Papaveraceae Argemone mexicana L., Burseraceae Bursera simaruba (L. Sarg., Acanthaceae Justicia spicigera Schltdl. and Selaginellaceae Selaginella lepidophylla (Hook. & Grev. Spring., have been used in Mexican traditional medicine to treat hypertension. The objective of this study was to further characterize the cardiovascular effects of the methanol extracts of such plants. Methods: The medicinal plants were collected and taxonomically identified; the methanol extract of each explored plant were administrated to conscious and unconscious male Wistar rats with and without glucose induced hypertension. The blood pressure and heart rate were evaluated before and after the extract administration. Vascular reactivity experiments were conducted in rat aortic rings obtained from rats with and without sugar induced hypertension, a model widely used to study such effects with cardiovascular agents. Results: After oral administration in normotensive conscious rats all tested extracts decreased the heart rate, such effect was only observed in hypertensive conscious rats after the administration of B. simaruba; only A. mexicana and B. simaruba decreased the blood pressure after oral administration. All extracts administrated by intravenous injection diminished the mean arterial pressure. Dose response curves to cumulative concentrations of all the extracts promote vascular relaxation in precontracted aortas from rats with and without sugar induced hypertension. Conclusions: The present study indicated that B. simaruba is worthy of further investigation as a potential phytotherapeutic agent for treating hypertension. [J Complement Med Res 2017; 6(3.000: 274-279

  20. Association between perceived racial discrimination and hypertension: findings from the ELSA-Brasil study.

    Mendes, Patrícia Miranda; Nobre, Aline Araújo; Griep, Rosane Härter; Guimarães, Joanna Miguez Nery; Juvanhol, Leidjaira Lopes; Barreto, Sandhi Maria; Pereira, Alexandre; Chor, Dóra

    2018-03-01

    "Pardos" and blacks in Brazil and blacks in the USA are at greater risk of developing arterial hypertension than whites, and the causes of this inequality are still little understood. Psychosocial and contextual factors, including racial discrimination, are indicated as conditions associated with this inequality. The aim of this study was to identify the association between perceived racial discrimination and hypertension. The study evaluated 14,012 workers from the ELSA-Brazil baseline population. Perceived discrimination was measured by the Lifetime Major Events Scale, adapted to Portuguese. Classification by race/color followed the categories proposed by Brazilian Institute of Geography and Statistics (IBGE). Hypertension was defined by standard criteria. The association between the compound variable - race/racial discrimination - and hypertension was estimated by Poisson regression with robust variance and stratified by the categories of body mass index (BMI) and sex. Choosing white women as the reference group, in the BMI 25kg/m2 and men in any BMI category, no effect of racial discrimination was identified. Despite the differences in point estimates of prevalence of hypertension between "pardo" women who reported and those who did not report discrimination, our results are insufficient to assert that an association exists between racial discrimination and hypertension.

  1. The OXIMAPA Study: Hypertension Control by ABPM and Association with Sleep Apnea Syndrome by Pulse Oximetry.

    Maricoto, Tiago; Silva, Eurico Alves Rodrigues; Damião, Pedro; Bastos, José Mesquita

    2017-02-27

    Ambulatory blood pressure monitoring by automatic device is the best blood pressure evaluation method and sleep apnea syndrome is the leading cause of poor control. Oximetry allows screening these individuals but its usefulness has been poorly explored in Primary Health Care. The aim was to evaluate the blood pressure control at the office and with ambulatory blood pressure monitoring by automatic device and to relate it to sleep apnea syndrome. We selected a sample of 50 participants, representative of 3036 hypertensive patients. The variables were: blood pressure value at the office and blood pressure with ambulatory blood pressure monitoring by automatic device; presence of criteria of sleep apnea syndrome in oximetry. The prevalence of uncontrolled blood pressure was 56% on office evaluation and 68% on ambulatory blood pressure monitoring by automatic device. It was found: 36% of daytime hypertension, 52% nocturnal hypertension, 40% non-dipper profile, 16% of white coat hypertension and 28% masked hypertension. The prevalence of sleep apnea syndrome was 16%. Blood pressure in ambulatory blood pressure monitoring by automatic device and blood pressure in office showed no statistically significant association (p = 0.761). We found a statistically significant association between sleep apnea syndrome and daytime hypertension (p = 0.019) and non-dipper profile (p = 0.005). Ambulatory blood pressure monitoring by automatic device detected more 12% of uncontrolled hypertension than office blood pressure. Sleep apnea syndrome is strongly associated with uncontrolled hypertension and oximetry may be a good screening method, but should be studied further.

  2. Longitudinal Study of Hypertensive Subjects With Type 2 Diabetes Mellitus: Overall and Cardiovascular Risk.

    Safar, Michel E; Gnakaméné, Jean-Barthélémy; Bahous, Sola Aoun; Yannoutsos, Alexandra; Thomas, Frédérique

    2017-06-01

    Despite adequate glycemic and blood pressure control, treated type 2 diabetic hypertensive subjects have a significantly elevated overall/cardiovascular risk. We studied 244 816 normotensive and 99 720 hypertensive subjects (including 7480 type 2 diabetics) attending medical checkups between 1992 and 2011. We sought to identify significant differences in overall/cardiovascular risk between hypertension with and without diabetes mellitus. Mean follow-up was 12.7 years; 14 050 all-cause deaths were reported. From normotensive to hypertensive populations, a significant progression in overall/cardiovascular mortality was observed. Mortality was significantly greater among diabetic than nondiabetic hypertensive subjects (all-cause mortality, 14.05% versus 7.43%; and cardiovascular mortality, 1.28% versus 0.7%). No interaction was observed between hemodynamic measurements and overall/cardiovascular risk, suggesting that blood pressure factors, even during drug therapy, could not explain the differences in mortality rates between diabetic and nondiabetic hypertensive patients. Using cross-sectional regression models, a significant association was observed between higher education levels, lower levels of anxiety and depression, and reduced overall mortality in diabetic hypertensive subjects, while impaired renal function, a history of stroke and myocardial infarction, and increased alcohol and tobacco consumption were significantly associated with increased mortality. Blood pressure and glycemic control alone cannot reverse overall/cardiovascular risk in diabetics with hypertension. Together with cardiovascular measures, overall prevention should include recommendations to reduce alcohol and tobacco consumption and improve stress, education levels, and physical activity. © 2017 American Heart Association, Inc.

  3. Late life socioeconomic status and hypertension in an aging cohort: the Atherosclerosis Risk in Communities Study.

    McDoom, M Maya; Palta, Priya; Vart, Priya; Juraschek, Stephen P; Kucharska-Newton, Anna; Diez Roux, Ana V; Coresh, Josef

    2018-06-01

    To investigate the association between individual and area-level socioeconomic status and hypertension risk among individuals later in life. We used Cox proportional hazards models to examine the association of socioeconomic status with incident hypertension using race-specific neighborhood socioeconomic status, median household income, and education among 3372 participants (mean age, 61 years) from the Atherosclerosis Risk in Communities Study at Visit 4 (1996-1998). Incident hypertension was defined as self-reported diagnosis or reported use of antihypertensive medications. Over a median follow-up time of 9.4 years, there were 1874 new cases of hypertension (62.1 per 1000 person-years). Overall, being in high as compared with low socioeconomic status categories was associated with a lower risk of developing hypertension in late life, with hazard ratios (95% confidence intervals) of 0.87 (0.77-0.98) for high neighborhood socioeconomic status tertile, 0.79 (0.69-0.90) for high individual income, and 0.75 (0.63-0.89) for college education after adjustment for traditional risk factors. These findings were consistent and robust whenever accounting for competing risks of all-cause mortality. No significant interactions by race and age (dichotomized at age 65) were observed. Among participants free of hypertension in midlife, high neighborhood and individual socioeconomic status are associated with a decreased risk of incident hypertension. Our findings support population-level interventions, such as blood pressure screening at senior centers and faith-based organizations, that are tailored to shift the distribution of blood pressure and reduce hypertension health inequalities among older adults.

  4. Study on the medical meteorological forecast of the number of hypertension inpatient based on SVR

    Zhai, Guangyu; Chai, Guorong; Zhang, Haifeng

    2017-06-01

    The purpose of this study is to build a hypertension prediction model by discussing the meteorological factors for hypertension incidence. The research method is selecting the standard data of relative humidity, air temperature, visibility, wind speed and air pressure of Lanzhou from 2010 to 2012(calculating the maximum, minimum and average value with 5 days as a unit ) as the input variables of Support Vector Regression(SVR) and the standard data of hypertension incidence of the same period as the output dependent variables to obtain the optimal prediction parameters by cross validation algorithm, then by SVR algorithm learning and training, a SVR forecast model for hypertension incidence is built. The result shows that the hypertension prediction model is composed of 15 input independent variables, the training accuracy is 0.005, the final error is 0.0026389. The forecast accuracy based on SVR model is 97.1429%, which is higher than statistical forecast equation and neural network prediction method. It is concluded that SVR model provides a new method for hypertension prediction with its simple calculation, small error as well as higher historical sample fitting and Independent sample forecast capability.

  5. Blood pressure reactivity to psychological stress predicts hypertension in the CARDIA study.

    Matthews, Karen A; Katholi, Charles R; McCreath, Heather; Whooley, Mary A; Williams, David R; Zhu, Sha; Markovitz, Jerry H

    2004-07-06

    A longstanding but controversial hypothesis is that individuals who exhibit frequent, large increases in blood pressure (BP) during psychological stress are at risk for developing essential hypertension. We tested whether BP changes during psychological stress predict incident hypertension in young adults. We used survival analysis to predict hypertensive status during 13 years of follow-up in a sample of >4100 normotensive black and white men and women (age at entry, 18 to 30 years) enrolled in the CARDIA study. BP responses to 3 psychological challenges--cold pressor, star tracing, and video game tasks--were measured. Hypertensive status was defined as use of antihypertensive medication or measured BP > or =140/90 mm Hg. After adjustment for race, gender, covariates (education, body mass index, age, and resting pressure), and their significant interactions, the larger the BP responses were to each of the 3 tasks, the earlier hypertension occurred (Pvideo game was apparent for men. Young adults who show a large BP response to psychological stress may be at risk for hypertension as they approach midlife.

  6. A Study on Plasma Renin Activity in Essential Hypertension

    Choe, Kang Won; Lee, Jung Sang; Cho, Bo Yeon; Koh, Chang Soon; Lee, Mun Ho

    1975-01-01

    Radioimmunoassay for the measurement of plasma renin activity (PRA) was performed in 43 normal Koreans and 45 patients with essential hypertension. Plasma samples were drawn in supine position in the morning and after upright posture for 4 hours. Urinary sodium excretion rates were measured in the concurrent 24 hour urine samples, an index of their sodium balance. The results were as follows: 1) There was an inverse correlation between 24 hr sodium excretion and PRA. The normal values of PRA in supine position ranged from 1.0 to 7.0 ng/ml/hr. when 24 hour sodium excretion were between 50 to 150 mEq. PRA in elderly tended to be low. 2) When stimulated by 4 hour upright posture, PRA increased by 2.6 times from the baseline value. 3) Of the 45 patients with essential hypertension, PRA was low in 10 cases (22.2%), normal in 28 cases (62.2%), and high in 7 cases (15.6%). 4) In the normal and high renin groups, who tended to be younger in ages, mean diastolic blood pressure and BUN were higher than in low renin group. Though hypertensive retinopathy and left ventricular hypertrophy in ECG were more prevalent in the former, no significant differences were noted as in the case of serum cholesterol. 5) There were 8 cases of cardiovascular complications (7 with cerebral vascular accident, 1 with myocardial infarction); 3 in low renin group (30%), 2 in normal renin (7.1%) and 3 in higher renin group (42.9%). This figure indicated higher rate of cardiovascular complications in higher renin groups, and lower rate in normal renin group. But the incidence of the complication was not significantly low in low renin group.

  7. XRF Studies of Trace Elements and Essential hypertension

    Chaudhri, M.A.; Paul, U.; Chaudhri, M.N.

    2011-01-01

    The elemental concentrations in the blood of fully mature spontaneously hypertensive rats [SHR] were compared with that of normotensive Wistar Kyoto rats [WKy] with an energy- dispersive XRF-system using a Rhodium X-ray tube. A number of elements, Na, Mg, P, Cl, S, K, Ca, Fe, Cu, Zn, Rb and Br, ranging in concentrations from a few ppm to around 1 % were measured in all the blood samples. It has been observed that the concentrations of elements Na, Cu, Zn and Br in whole blood of SHR are about 5%, 17%, 7% and 21% higher respectively than in the WKy- group

  8. Study of left ventricular diastolic dysfunction in recently diagnosed hypertensives in Central Nepal

    Shankar Laudari

    2016-03-01

    Full Text Available CORRECTION: The conclusion on the PDF of this article was replaced on 17th April 2016. The corrected PDF is now available by clicking on the link below.Background & Objectives: Ectopic Left ventricular diastolic dysfunction is now well established as a cause of left sided heart failure and as a powerful predictor of cardiovascular events. It is attributed mostly to systemic hypertension. The objective of the study was to determine the prevalence of left ventricular diastolic dysfunction in recently diagnosed hypertensives in Nepalese population using echocardiography. Materials & Methods: Two-dimensional echocardiography was performed on 120 newly diagnosed patients of systemic hypertension. Transmitral Doppler indexes of diastolic function, Valsalva maneuver applied to the same mitral inflow pattern, pulsed tissue Doppler of the mitral annulus, deceleration time, isovolumic relaxation time and pulmonary venous flow pattern.Results: The age of the patients in our study ranged from 20 to 84 years with mean age of 50years±14.13 years (standard deviation and male:female ratio being 1.35:1. Hypertensive patients were highest in age group 45-64 years followed by 25-44 years in both the genders. Majority of the patients had stage 1 hypertension (44.16% followed by stage 2 HTN in 34.17% and pre-hypertension in 21.67%. The majority of the patients in our study had Grade 1 LVDD (66.67%, 10.83% patients had Grade II LVDD, only 2.50% had non-restrictive Grade III LVDD and none had LVDD-IV. Stage II hypertensives had more LVDD(I+II+III: 39/41-95.12% than stage I hypertensives(39/53-73.58% and pre-hypertensives (8/26-30.77%. The association between stages of systemic HTN and LVDD was found to be highly statistically significant (p=0.002. Conclusion: Our study showed that left ventricular diastolic dysfunction is a common entity in Nepalese population with systemic hypertension.JCMS Nepal. 2016;12(1:14-18.

  9. Job strain and risk of cardiovascular events in treated hypertensive Japanese workers: hypertension follow-up group study.

    Uchiyama, Shuji; Kurasawa, Takashi; Sekizawa, Toshihiro; Nakatsuka, Hiroshi

    2005-03-01

    In Japan, Karoshi, which means "death from overwork", has become a focus of social concern. However, no previous study has examined long working hours and job strain simultaneously in relation to incidence of cardiovascular events (CVE) in Japanese workers. We prospectively evaluated the relation between job strain or long working hours and risk of CVE in treated hypertensives during the years 1994-2000. In this study, we followed a sample of 1,615 participants (908 men and 707 women) aged 40-65 yr who were working more than 5 working hours per day. Participants completed questions about work-related conditions and lifestyle variables at baseline, and were free of diagnosed cardiovascular disease, stroke or cancer. Job strain (the combination of job demands and job control) was assessed using a simple questionnaire developed with reference to Karasek's model. The main outcome measure was incidence of CVE. During the mean follow-up period of 5.6 yr, we documented 38 cases of initial CVE. Analyses were conducted using the Cox proportional hazard model. We found a significant association between incidence of CVE and job strain categories, but not long working hours. Multivariate relative risks for CVE in active jobs and high strain jobs overall were 2.89 (95% CI: 1.33-6.28) and 2.45 (95% CI: 0.87-6.93); for men 2.94 (95% CI: 1.29-6.73) and 1.86 (95% CI: 0.51-6.75), and for women 3.97 (95% CI: 0.34-46.88) and 9.05 (95% CI: 1.17-69.86), respectively. In conclusion, active jobs and high strain jobs were associated with increased risk of CVE for treated hypertensive workers.

  10. Association between Dietary Patterns and the Risk of Hypertension among Chinese: A Cross-Sectional Study

    Pei-Fen Zheng

    2016-04-01

    Full Text Available Epidemiological studies of different dietary patterns and the risk of hypertension among a middle-aged Chinese population remain extremely scare. Thus, the aim of this study was to identify dietary patterns and investigate the relationship between dietary patterns and the risk of hypertension among Chinese adults aged 45–60 years. The present cross-sectional study includes 2560 participants who reported their dietary intake using a validated food frequency questionnaire (FFQ. Dietary patterns were identified using factor analysis. Anthropometric measurements were obtained using standardized procedures. We used log-binomial regression analysis to examine the associations between dietary patterns and hypertension risk. Four major dietary patterns were identified and labeled as traditional Chinese, animal food, western fast-food, and high-salt patterns. After adjusting for potential confounders, participants in the highest quartile of animal food pattern scores had a greater prevalence ratio (PR for hypertension (PR = 1.26; 95% confidence interval (CI: 1.064–1.727; p < 0.05 in comparison to those from the lowest quartile. Compared with the lowest quartile of high-salt pattern, the highest quartile had a higher prevalence ratio for hypertension (PR = 1.12; 95% CI: 1.013–1.635; p < 0.05. Conclusions: Our findings indicated that animal food and high-salt patterns were associated with increased risk of hypertension, while traditional Chinese and western fast-food patterns were not associated with the risk of hypertension. Further prospective studies are warranted to confirm these findings.

  11. Neonatal hypertension – a long-term pilot follow-up study

    Chaudhari T

    2013-06-01

    Full Text Available Tejasvi Chaudhari,1 Michael C Falk,2,3 Rajeev Jyoti,2,4 Susan Arney,5 Wendy Burton,5 Alison L Kent1,2 1Department of Neonatology, Canberra Hospital, Woden, ACT, Australia; 2Australian National University Medical School, Canberra, ACT, Australia; 3Department of Nephrology, 4Medical Imaging Department, 5Centre for Newborn Care, Canberra Hospital, Woden, ACT, Australia Background: Neonatal hypertension occurs in up to 3% of neonates, more commonly in those admitted to neonatal intensive care. The aims of this study were to review renal function and renal volumes in children who had a history of neonatal hypertension. Methods: Children with a history of neonatal hypertension from January 2001 to December 2008 were included in the study during 2011. Blood pressure, weight, height, and body mass index were recorded. Renal ultrasound with 3D volume, urine for electrolytes, albumin, ß2 microglobulin, and blood for electrolytes, urea, creatinine, calcium, phosphate, renin, and aldosterone were collected depending on parental consent. Results: Of the 41 neonates with neonatal hypertension, eleven (27% were included in the study (six died; 24 moved interstate or declined involvement. One child (9% was still on antihypertensive medication and one was found to be hypertensive on review. This child had small volume kidneys and albuminuria. Three out of nine renal volume measurements were low (33% and two out of eleven had renal scarring (18%. The six available renin/aldosterone results were normal. Conclusion: This study suggests there are long-term renal and blood pressure implications for neonates with hypertension and ongoing surveillance of blood pressure and renal function should be performed throughout childhood and into early adulthood. Keywords: neonate, hypertension, renal ultrasound, 3D

  12. Hypertension: adherence to treatment in rural Bangladesh – findings from a population-based study

    Khanam, Masuma Akter; Lindeboom, Wietze; Koehlmoos, Tracey Lynn Perez; Alam, Dewan Shamsul; Niessen, Louis; Milton, Abul Hasnat

    2014-01-01

    Background Poor adherence has been identified as the main cause of failure to control hypertension. Poor adherence to antihypertensive treatment is a significant cardiovascular risk factor, which often remains unrecognized. There are no previous studies that examined adherence with antihypertensive medication or the characteristics of the non-adherent patients in Bangladesh. Objective This paper aims to describe hypertension and factors affecting adherence to treatment among hypertensive persons in rural Bangladesh. Design The study population included 29,960 men and women aged 25 years and older from three rural demographic surveillance sites of the International Center for Diarrheal Disease Research, Bangladesh (icddr,b): Matlab, Abhoynagar, and Mirsarai. Data was collected by a cross-sectional design on diagnostic provider, initial, and current treatment. Discontinuation of medication at the time of interview was defined as non-adherence to treatment. Results The prevalence of hypertension was 13.67%. Qualified providers diagnosed only 53.5% of the hypertension (MBBS doctors 46.1 and specialized doctors 7.4%). Among the unqualified providers, village doctors diagnosed 40.7%, and others (nurse, health worker, paramedic, homeopath, spiritual healer, and pharmacy man) each diagnosed less than 5%. Of those who started treatment upon being diagnosed with hypertension, 26% discontinued the use of medication. Age, sex, education, wealth, and type of provider were independently associated with non-adherence to medication. More men discontinued the treatment than women (odds ratio [OR] 1.74, confidence interval [CI] 1.48–2.04). Non-adherence was greater when hypertension was diagnosed by unqualified providers (OR 1.52, CI 1.31–1.77). Hypertensive patients of older age, least poor quintile, and higher education were less likely to be non-adherent. Patients with cardiovascular comorbidity were also less likely to be non-adherent to antihypertensive medication (OR 0

  13. Prevalence of hypertension in adults in the Šumadija district, Serbia: A cross sectional study

    Marinković Mirjana

    2014-01-01

    Full Text Available Background/Aim. World Health Organization (WHO studies on the global level have shown that one of the major problems of the public health is hypertension. Blood pressure level greater than 140/90 mmHg is directly and predictively linked to other cardiovascular diseases. The aim of this research was to determine the prevalence of hypertension and the risk groups among the adult population in the Šumadija District, Serbia. Methods. This cross-sectional study included 1.669 elderly population of the Šumadija District, aged 25-74. The study was performed according to the protocol of the Country Wide Integrated Noncommunicable Disease Intervention (CINDI international program. Results. In the Šumadija District more than a half of the population aged 25-74 suffers from hypertension (53%. In the Šumadija District 9% of population has undiagnosed hypertension. In the group of people familiar with their high blood pressure problems, good disease control is achieved in only 46% of them. Statistically, hypertension occurs more frequently in males aged 45-74, of lower education, and in rural population. This is the target group for implementation of the high risk strategy. Statistically, there is a higher prevalence of hypertension in people suffering from myocardial infarction (p = 0.04, angina pectoris (p = 0.00, other cardiac diseases (cardiac insufficiency (p = 0.00 and cerebrovascular crises (p = 0.04. Conclusion. A continuous increase of patients with hypertension, coupled with the developed complications and increase in cardiovascular diseases as a cause of death, points to the lack of effective access to prevention and early detection of these diseases in the primary health care among the risk groups in Šumadija.

  14. Hyperuricemia and risk of incident hypertension: a systematic review and meta-analysis of observational studies.

    Ji Wang

    Full Text Available Observational studies of the relationship between hyperuricemia and the incidence of hypertension are controversial. We conducted a systematic review and meta-analysis to assess the association and consistency between uric acid levels and the risk of hypertension development.We searched MEDLINE, EMBASE, CBM (Chinese Biomedicine Database through September 2013 and reference lists of retrieved studies to identify cohort studies and nested case-control studies with uric acid levels as exposure and incident hypertension as outcome variables. Two reviewers independently extracted data and assessed study quality using Newcastle-Ottawa Scale. Extracted information included study design, population, definition of hyperuricemia and hypertension, number of incident hypertension, effect sizes, and adjusted confounders. Pooled relative risks (RRs and corresponding 95% confidence intervals (CIs for the association between hyperuricemia and risk of hypertension were calculated using a random-effects model.We included 25 studies with 97,824 participants assessing the association between uric acid and incident hypertension in our meta-analysis. The quality of included studies is moderate to high. Random-effects meta-analysis showed that hyperuricemia was associated with a higher risk of incident hypertension, regardless of whether the effect size was adjusted or not, whether the data were categorical or continuous as 1 SD/1 mg/dl increase in uric acid level (unadjusted: RR = 1.73, 95% CI 1.46∼2.06 for categorical data, RR = 1.22, 95% CI 1.03∼1.45 for a 1 SD increase; adjusted: RR = 1.48, 95% CI 1.33∼1.65 for categorical data, RR = 1.15, 95% CI 1.06∼1.26 for a 1 mg/dl increase, and the risk is consistent in subgroup analyses and have a dose-response relationship.Hyperuricemia may modestly increase the risk of hypertension incidence, consistent with a dose-response relationship.

  15. Prevalence of hypertension in rural areas of china: a meta-analysis of published studies.

    Xiaofang Chen

    Full Text Available Hypertension is one of the leading causes of disease burden across the world. In China, the latest nationwide survey of prevalence of hypertension was ten year ago, and data in rural areas is little known. More information about hypertension prevalence could help to improve overall antihypertensive health care. We aimed to estimate the pooled prevalence of hypertension in rural areas of China.Comprehensive electronic searches of PubMed, Web of Knowledge, Chinese Web of Knowledge, Wangfang, Weipu and SinoMed databases were conducted to identify any study in each database published from January 1, 2004 to December 31, 2013, reporting the prevalence of hypertension in Chinese rural areas. Prevalence estimates were stratified by age, area, sex, publication year, and sample size. All statistical calculations were made using the Stata Version 11.0 (College Station, Texas and Statsdirect Version 2.7.9.We identified 124 studies with a total population of 3,735,534 in the present meta-analysis. Among people aged 18 years old in Chinese rural areas, the summarized prevalence is 22.81% (19.41%-26.41%. Subgroup analysis shows the following results: for male 24.46% (21.19%-27.89%, for female 22.17% (18.25%-26.35%. For 2004-2006: 18.94% (14.41%-23.94%, for 2007-2009, 21.24% (15.98%-27.01% for 2010-2013: 26.68%, (20.79%-33.02%. For Northern region 25.76% (22.36%-29.32%, for Southern region 19.30%, (15.48%-24.08%.The last decade witnessed the growth in prevalence of hypertension in rural areas of China compared with the fourth national investigation, which has climbed the same level as the urban area. Guidelines for screening and treatment of hypertension in rural areas need to be given enough attention.

  16. The Current Situation of Hypertension among Rural Minimal Assurance Family Participants in Liaoning (China): A Cross-Sectional Study.

    Chen, Yintao; Yu, Shasha; Chen, Shuang; Guo, Xiaofan; Li, Yuan; Li, Zhao; Sun, Yingxian

    2016-12-02

    In China, the prevalence of hypertension is increasing and is showing an epidemic accelerating trend. However, there is a lack of studies reporting the hypertension status of rural residents with minimum living allowances. We performed a cross-sectional study including 11,435 (5285 men and 6150 women) from the general population aged ≥35 years in the Liaoning Province of China from 2012 to 2013, of which 1258 (11.0%) participants came from minimal assurance families. Anthropometric measurements, laboratory examinations and self-reported lifestyle factor information were collected by trained personnel. Multivariate logistic regression was used to detect the association between socioeconomic status (SES) and the risk of hypertension. We found that the prevalence of hypertension was as high as 61.9% in participants from minimal assurance families and the odd ratio for hypertension was 1.32 (95% CI: 1.15-1.52). The awareness, treatment, and control rates among treated hypertensive participants did not increase with higher level of income and education. In the total sample, the lower income levels increased the risk for hypertension, but education didn't show a significant association with hypertension. Thus, there is a severe hypertension situation in the Liaoning rural population of minimal assurance families, which need more attention and prevention and control measures for hypertension.

  17. Uric Acid Is a Strong Risk Marker for Developing Hypertension From Prehypertension: A 5-Year Japanese Cohort Study.

    Kuwabara, Masanari; Hisatome, Ichiro; Niwa, Koichiro; Hara, Shigeko; Roncal-Jimenez, Carlos A; Bjornstad, Petter; Nakagawa, Takahiko; Andres-Hernando, Ana; Sato, Yuka; Jensen, Thomas; Garcia, Gabriela; Rodriguez-Iturbe, Bernardo; Ohno, Minoru; Lanaspa, Miguel A; Johnson, Richard J

    2018-01-01

    Prehypertension frequently progresses to hypertension, a condition associated with high morbidity and mortality from cardiovascular diseases and stroke. However, the risk factors for developing hypertension from prehypertension remain poorly understood. We conducted a retrospective cohort study using the data from 3584 prehypertensive Japanese adults (52.1±11.0 years, 2081 men) found to be prehypertensive in 2004 and reexamined in 2009. We calculated the cumulative incidences of hypertension over 5 years, examined risk factors, and calculated odds ratios (ORs) for developing hypertension after adjustments for age, sex, body mass index, smoking and drinking habits, baseline systolic and diastolic blood pressure, pulse rate, diabetes mellitus, dyslipidemia, chronic kidney disease, and serum uric acid levels. The additional analysis evaluated whether serum uric acid (hyperuricemia) constituted an independent risk factor for developing hypertension. The cumulative incidence of hypertension from prehypertension over 5 years was 25.3%. There were no significant differences between women and men (24.4% versus 26.0%; P =0.28). The cumulative incidence of hypertension in subjects with hyperuricemia (n=726) was significantly higher than those without hyperuricemia (n=2858; 30.7% versus 24.0%; P hypertension from prehypertension were age (OR, 1.023; P hypertension from prehypertension. Further studies are needed to determine whether treatment of hyperuricemia in prehypertensive subjects could impede the onset of hypertension. © 2017 American Heart Association, Inc.

  18. Uncontrolled hypertension and associated factors among adult hypertensive patients on follow-up at Jimma University Teaching and Specialized Hospital: cross-sectional study

    Tesfaye B

    2017-03-01

    Full Text Available Bekele Tesfaye,1 Dessalegn Haile,1 Benalfew Lake,1 Tefera Belachew,2 Temamen Tesfaye,3 Habtamu Abera4 1Department of Nursing, College of Health Science, Debre Markos University, Debre Markos, 2Department of Population and Family Health, 3Department of Nursing and Midwifery, College of Health Science, Jimma University, Jimma, 4Department of Nursing and Midwifery, College of Health Sciences, School of Allied Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia Introduction: Hypertension, including poorly controlled blood pressure, is the major global health problem that affects one billion people worldwide. Limited studies have been conducted on prevalence of uncontrolled hypertension and associated factors among adult hypertensive patients in Ethiopia.Objective: The aim of this study was to determine the prevalence of uncontrolled hypertension and associated factors among adult hypertensive patients at Jimma University Teaching and Specialized Hospital.Methods: Institution-based cross-sectional study was conducted at the chronic illness clinic of Jimma University Specialized and Teaching hospital from March 09 to April 13, 2016. A total of 345 hypertensive patients were selected using systematic sampling technique. Data were collected using structured questionnaire through face-to-face exit interview and chart review. Data were analyzed using Statistical Package for the Social Sciences (SPSS version 20.0 software. The bivariate and multivariable analysis was done to identify factors of uncontrolled hypertension.Results: More than half, 52.7%, of the patients had uncontrolled hypertension. Lack of awareness of hypertension-related complications (adjusted odds ratio [AOR]=2.140, 95% confidence interval [CI]=1.272–3.600, p=0.004, nonadherent to smoking abstinence (AOR=3.935, 95% CI=1.065–14.535, p=0.004, nonadherent to alcohol abstinence (AOR=2.477, 95% CI=1.074–5.711, p=033, Khat (Catha edulis chewing (AOR=2.518, 95% CI=1.250–5

  19. Blood Pressure Control in Hypertensive Patients in the "Hiperdia Program": A Territory-Based Study

    Clarita Silva de Souza

    2014-06-01

    Full Text Available Background: Systemic hypertension is highly prevalent and an important risk factor for cardiovascular events. Blood pressure control in hypertensive patients enrolled in the Hiperdia Program, a program of the Single Health System for the follow-up and monitoring of hypertensive patients, is still far below the desired level. Objective: To describe the epidemiological profile and to assess blood pressure control of patients enrolled in Hiperdia, in the city of Novo Hamburgo (State of Rio Grande do Sul, Brazil. Methods: Cross-sectional study with a stratified cluster random sample, including 383 adults enrolled in the Hiperdia Program of the 15 Basic Health Units of the city of Porto Alegre, conducted between 2010 and 2011. Controlled blood pressure was defined as ≤140 mmHg × 90 mmHg. The hypertensive patients were interviewed and their blood pressure was measured using a calibrated aneroid device. Prevalence ratios (PR with 95% confidence interval, Wald's χ2 test, and simple and multiple Poisson regression were used in the statistical analysis. Results: The mean age was 63 ± 10 years, and most of the patients were females belonging to social class C, with a low level of education, a sedentary lifestyle, and family history positive for systemic hypertension. Diabetes mellitus (DM was observed in 31%; adherence to the antihypertensive treatment in 54.3%; and 33.7% had their blood pressure controlled. DM was strongly associated with inadequate BP control, with only 15.7% of the diabetics showing BP considered as controlled. Conclusion: Even for hypertensive patients enrolled in the Hiperdia Program, BP control is not satisfactorily reached or sustained. Diabetic hypertensive patients show the most inappropriate BP control.

  20. Cardiovascular Health and Incident Hypertension in Blacks: JHS (The Jackson Heart Study).

    Booth, John N; Abdalla, Marwah; Tanner, Rikki M; Diaz, Keith M; Bromfield, Samantha G; Tajeu, Gabriel S; Correa, Adolfo; Sims, Mario; Ogedegbe, Gbenga; Bress, Adam P; Spruill, Tanya M; Shimbo, Daichi; Muntner, Paul

    2017-08-01

    Several modifiable health behaviors and health factors that comprise the Life's Simple 7-a cardiovascular health metric-have been associated with hypertension risk. We determined the association between cardiovascular health and incident hypertension in JHS (the Jackson Heart Study)-a cohort of blacks. We analyzed participants without hypertension or cardiovascular disease at baseline (2000-2004) who attended ≥1 follow-up visit in 2005 to 2008 or 2009 to 2012 (n=1878). Body mass index, physical activity, diet, cigarette smoking, blood pressure (BP), total cholesterol, and fasting glucose were assessed at baseline and categorized as ideal, intermediate, or poor using the American Heart Association's Life's Simple 7 definitions. Incident hypertension was defined at the first visit wherein a participant had systolic BP ≥140 mm Hg, diastolic BP ≥90 mm Hg, or self-reported taking antihypertensive medication. The percentage of participants with ≤1, 2, 3, 4, 5, and 6 ideal Life's Simple 7 components was 6.5%, 22.4%, 34.4%, 25.2%, 10.0%, and 1.4%, respectively. No participants had 7 ideal components. During follow-up (median, 8.0 years), 944 (50.3%) participants developed hypertension, including 81.3% with ≤1 and 11.1% with 6 ideal components. The multivariable-adjusted hazard ratios (95% confidence interval) for incident hypertension comparing participants with 2, 3, 4, 5, and 6 versus ≤1 ideal component were 0.80 (0.61-1.03), 0.58 (0.45-0.74), 0.30 (0.23-0.40), 0.26 (0.18-0.37), and 0.10 (0.03-0.31), respectively ( P trend hypertension risk. © 2017 American Heart Association, Inc.

  1. The Effectiveness of Hypertensive Management Programs and Social Support in Primary Health Care Systems: Preliminary Study

    Pantip Sangprasert

    2016-11-01

    Full Text Available This quasi-experimental study used inclusion criteria obtaining samples taken from high-risk and grade I hypertensive patients aged 35 to 59 without hypertensive complications. The two related groups comprised 36 individuals. Both were enrolled in a hypertensive management program comprising health education strategies, respiratory training, advice on limiting salt and fat intake, exercise, group discussion with social support, telephon counseling, and home visits. Three perception and preventive behavior questionnaires and home behavior records collected data according to individual hypertension risk factors. The study was carried out for four months. Descriptive statistics and a paired t-test were used. Results showed a statistical significance difference with increased total mean scores with the following variances:healthstatus,self-efficacyanddecreasedbarrierperception(p=.000, .008and.022, respectively. There was noticeable improvement in exercise and stress management, but no significant change in overall preventive behavior for hypertension (p >.05. Systolic and diastolic blood pressure and heart rate were lower (p .05. Primary healthcare services should also be a strategic development, especially focus socially-supported on mental wellbeing whichis beneficial for riskandhypertensive groups.

  2. Better physician-patient communication; an important milestone in control of hypertension, a multicenter study from karachi, pakistan

    Almas, Y.; Bhamani, F.

    2014-01-01

    Control of hypertension is an important cornerstone in prevention of cardiovascular morbidity and mortality. This study was designed to compare physician encounter score in patients with controlled and uncontrolled hypertension. It was conducted at three tertiary care hospitals in Karachi. Patients were categorized into controlled and uncontrolled hypertension based on their initial blood pressure readings on presentation. Primary outcome variable was control of hypertension and physician encounter score (a composite score of 12 item question) was the main candidate variable. Higher scores reflected favorable encounter with physician. Mean age of participants was 57.7 +- 12 years; 224 (50.1%) were men. Controlled hypertension was present in 72.3% (323) and uncontrolled hypertension was present in 27.4% (124). Mean physician encounter score in uncontrolled hypertensive was 7.25 +- 2.64 versus 7.83 +- 2.22 (p=0.02) in controlled hypertensive. Patient-physician encounter is an important milestone in control of hypertension in hypertensive patients and directly translates into better adherence to antihypertensives in these patients. (author)

  3. Hypertension in the Parsi community of Bombay: a study on prevalence, awareness and compliance to treatment

    Kuruvilla Thomas

    2003-01-01

    Full Text Available Abstract Background Uncontrolled hypertension (HT is an established risk factor for the development of vascular diseases. Prevalence varies in different communities and no such study has been conducted in the Parsi community living in Bombay, India. The objectives of this study were to determine the prevalence, awareness, compliance to medication and control of HT in this community. Method We used a 1 in 4 random selection of subjects who were ≥ 20 years of age. A questionnaire was administered and the blood pressure (BP was measured by a doctor. HT was defined as diastolic blood pressure (DBP ≥ 90 mm Hg ± systolic pressure (SBP ≥ 140 mm Hg. Isolated systolic hypertension (ISH was defined as SBP ≥ 160 mm Hg with DBP Results 2879 subjects ≥ 20 years of age were randomly selected of which 2415 (84% participated in the study. The overall prevalence of HT in the community was 36.4%, of whom 48.5% were unaware of their hypertensive status. Of those aware of having HT, 36.4% were non-compliant with their anti-hypertensive drugs and only 13.6% had optimally controlled HT. Prevalence of ISH using the present criteria was 19.5% and 73% of hypertensives ≥ 60 years had ISH. Conclusion This study shows that prevalence of HT in the Parsi community is high and nearly half are unaware of their hypertensive status. ISH is the dominant form of HT in the elderly. Compliance to treatment is poor and optimal BP control is achieved in only a small minority. The study highlights the need for regular screening coupled with educational programs to detect and optimally treat HT in the community.

  4. Relationship Between Prehypertension/Hypertension and Periodontal Disease: A Prospective Cohort Study.

    Kawabata, Yuya; Ekuni, Daisuke; Miyai, Hisataka; Kataoka, Kota; Yamane, Mayu; Mizutani, Shinsuke; Irie, Koichiro; Azuma, Tetsuji; Tomofuji, Takaaki; Iwasaki, Yoshiaki; Morita, Manabu

    2016-03-01

    Most cross-sectional studies have found a significant positive relationship between periodontal disease and prehypertension/hypertension. However, these studies had limitations and there are few prospective cohort studies in young adults. The purpose of this prospective cohort study was to investigate whether periodontal disease was related to prehypertension/hypertension in Japanese university students. Students (n = 2,588), who underwent health examinations before entering university and before graduation, were included in the analysis. The association between periodontal disease such as the percentage of bleeding on probing (BOP) and community periodontal index (CPI) scores, and change in blood pressure status was determined. At the reexamination, the numbers of participants with prehypertension (systolic blood pressure 120-139mm Hg or diastolic blood pressure 80-89mm Hg) and hypertension (≥140/90mm Hg) were 882 (34.1%) and 109 (4.2%), respectively. In a logistic regression model, the risk of hypertension was significantly associated with male (odds ratio (OR): 6.31; 95% confidence interval (CI): 2.63-15.13; P periodontal disease defined as the presence of both probing pocket depth (PPD) ≥ 4mm and BOP ≥ 30% at baseline (OR: 2.74; 95% CI: 1.19-6.29; P = 0.02) in participants with prehypertension at baseline. On the other hand, the risk of prehypertension was not associated with presence of periodontal disease (OR: 0.93; 95% CI: 0.51-1.70; P = 0.82). In the short-term prospective cohort study, a significant association between presence of periodontal disease and hypertension was observed in Japanese university students. © American Journal of Hypertension, Ltd 2015. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  5. Study of prevalence of type 2 diabetes mellitus and hypertension in overweight and obese people

    Abhijit Mandal

    2014-01-01

    Full Text Available Context: In recent years, there has been a marked change in life-style of South Asian countries caused by economic growth, affluence, urbanization and dietary westernization. Few studies on the prevalence of obesity, hypertension and diabetes in the Indian population have been reported. However, there has been scarce literature on the study of prevalence of type 2 diabetes mellitus (DM and Hypertension in overweight and obese people in India with criteria suggested by World Health Organization (WHO for Asians. Information on such public health issues would provide evidence based data to develop guidelines and policies on this subject. Aim: The aim of this article is to determine the prevalence of hypertension and type 2 DM in overweight and obese people. Setting and Design: A cross-sectional study consisted of people selected from the out-patient department and indoors of a large defense hospital in a semi urban area of Assam. Materials and Methods: Patients with overweight and obesity, reporting for consultation and medical examination were taken into the study. The data collected was analyzed using the criteria for overweight, obesity, diabetes and hypertension defined by WHO, Joint National Committee VII and International Diabetes Federation, American Diabetes Association. A descriptive statistical analysis has been carried out in the study. Results: A total of 300 people were the subject population of this study. Among the subject population, there were 97 overweight and 203 obese. The 56 subjects were found to be diabetic. The prevalence of type 2 DM in overweight subjects was 15.5% and in obese was 20.2% and overall was 18.7%. Prevalence of hypertension in the overweight population was 8.2% and in obese was 22.2% and overall found to be 17.7%. Conclusions: The prevalence of type 2 DM, hypertension in the obese group of the study population were found to be 20.2%, 22.2% and in the overweight population were 15.5% and 8.2%, respectively

  6. Frequency and determinants of white coat hypertension in mild to moderate hypertension: a primary care-based study. Monitorización Ambulatoria de la Presión Arterial (MAPA)-Area 5 Working Group.

    Martínez, M A; García-Puig, J; Martín, J C; Guallar-Castillón, P; Aguirre de Cárcer, A; Torre, A; Armada, E; Nevado, A; Madero, R S

    1999-03-01

    Most of the previous studies on white coat hypertension were performed in hypertension clinics or academic settings and included relatively small series of patients. Consequently, the prevalence of white coat hypertension in primary care settings and the clinical and epidemiologic characteristics of this subgroup of patients are not well known. We performed this study to estimate the frequency of white coat hypertension in a population of mildly to moderately hypertensive subjects attended in a primary care setting and to examine possible epidemiologic and clinical factors that may identify these patients. Patients included in the study underwent clinical interview, measurement of clinic blood pressure (BP) on three visits, determination of serum lipids, glucose, uric acid, and urinary albumin excretion, 24-h ambulatory BP monitoring, and M-mode and Doppler echocardiography. Patients were classified as white coat hypertensives if their daytime ambulatory BP were < 135/85 mm Hg. We studied 345 patients, 136 (39%) of whom were diagnosed with white coat hypertension. The frequency of white coat hypertension was inversely proportional to the severity of clinic BP values. The diagnosis of white coat hypertension was independently associated with female gender and low educational level. Left ventricular mass index and urinary albumin excretion were lower in the white-coat hypertensive group compared with the group with sustained hypertension. Our results show that a high proportion of patients with mild to moderate hypertension attended in a primary care setting have white coat hypertension. Some clinical characteristics may be helpful in the identification of this group of subjects. White coat hypertensives show less target-organ damage than sustained hypertensive patients.

  7. Diet quality is associated with obesity and hypertension in Australian adults: a cross sectional study

    Katherine M. Livingstone

    2016-10-01

    Full Text Available Abstract Background Poor diet, characterized by a low diet quality score, has been associated with greater prevelence of obesity and hypertension. However, the evidence is inconsistent across diet quality scores and by sex. The aim was to investigate the relationship between diet quality and obesity and hypertension. Methods Adults (n = 4908; age 45.2 ± 0.24 years were included from the cross-sectional Australian Health Survey 2011–2013. Two 24-h dietary recalls were used to derive the dietary guideline index (DGI and recommended food score (RFS. Logistic regression investigated relationships between diet quality score and odds ratio of obesity, hypertension and obesity-associated hypertension. Results In the highest tertile of DGI, but not RFS, individuals were less likely to be obese (men: OR 0.64, CI: 0.45, 0.92, P-trend = 0.014; women: 0.68, 0.48, 0.96, P-trend = 0.025 and to have central adiposity (men: 0.68, 0.48, 0.97, P-trend = 0.030; women: 0.53, 0.37, 0.77, P-trend = 0.001 compared with the lowest tertile. Men, but not women, in the highest tertile of DGI and RFS were less likely to be hypertensive (DGI: 0.56, 0.37, 0.85, P-trend = 0.006; RFS: 0.62, 0.41, 0.94, P-trend = 0.021 compared with the lowest tertile. In men with obesity, but not normal weight men or women, those in the highest tertile of DGI were less likely to be hypertensive (0.53, 0.36, 0.78, P-trend = 0.001 compared with the highest tertile. Conclusions Higher diet quality, as estimated using DGI, was associated with lower odds ratio of obesity in men and women. Odds ratio of hypertension was lower in men, but not women, with a high diet quality score compared with a low score, while obesity-associated hypertension was only associated with diet quality score in men with obesity. Longitudinal studies are needed to evaluate whether diet quality predicts risk of obesity and hypertension.

  8. In vivo neutron activation analysis in a study of cadmium and hypertension in South Wales

    Morgan, W.D.; Cummins, P.E.; Elwood, P.C.; Evans, C.J.; Dutton, J.; Sivyer, A.

    1980-01-01

    There is conflicting evidence concerning the influence of cadmium on the incidence of essential hypertension. Blood and urine are not very good indicators of body burden, and furthermore, the importance in such studies of matching for age and smoking habit has often been overlooked. In this respect, the technique for cadmium measurements in vivo by neutron capture prompt gamma analysis has many advantages. Fast neutron irradiation of a subject generates a thermal neutron flux at depths within the body such that capture reactions may occur. These will take place predominantly with hydrogen but also with cadmium and other body elements depending upon their cross-section and tissue abundance. The characteristic 559 keV prompt gamma rays from cadmium are detected using a 21% efficient Ge(Li) detector which is shielded against neutron and gamma radiation emerging both from the source and shield and from the subject. A detection limit (2 s.d. of the background) of 3.2 mg cadmium in the kidney is achieved for an organ dose of 0.3 rem delivered in 33 min. A study of 30 hypertensive subjects and 30 controls, matched for age, sex and smoking habit, has shown a mean kidney cadmium content of 3.3 +- 2.3 mg in the hypertensives which is not significantly different from the 4.4 +- 2.7 mg in the controls. However, in 13 pairs of non-smokers within the study, the mean value of 2.4 +- 2.5 mg in the hypertensives was significantly (p < 0.05) lower than the 3.9 +- 1.2 mg observed in the controls. Since the hypertensive patients had been treated for several years this raises the question of whether such therapy has reduced the level of renal cadmium below that which might be found in untreated hypertensives. Finally, the study confirmed the previously reported association between cigarette smoking and cadmium burden

  9. Ocular Hypertension

    ... Español Eye Health / Eye Health A-Z Ocular Hypertension Sections What Is Ocular Hypertension? Ocular Hypertension Causes ... Hypertension Diagnosis Ocular Hypertension Treatment What Is Ocular Hypertension? Leer en Español: ¿Qué es la hipertensión ocular? ...

  10. Dairy consumption, systolic blood pressure, and risk of hypertension: Mendelian randomization study

    This study examined whether previous observed inverse associations of dairy intake with systolic blood pressure and risk of hypertension were causal. A Mendelian randomization study was employed, using the single nucleotide polymorphism rs4988235 related to lactase persistence as an instrumental var...

  11. Diabetes mellitus, hypertension and medial temporal lobe atrophy: the LADIS study

    Korf, E S C; van Straaten, E C W; de Leeuw, F-E

    2007-01-01

    HYPOTHESIS: Based on recent findings on the association between vascular risk factors and hippocampal atrophy, we hypothesized that hypertension and diabetes mellitus (DM) are associated with medial temporal lobe atrophy (MTA) in subjects without disability, independent of the severity of white...... matter hyperintensities. METHODS: In the Leukoaraiosis And DISability in the elderly (LADIS) study, we investigated the relationships between DM, hypertension, blood pressure and MTA in 582 subjects, stratified by white matter hyperintensity severity, using multinomial logistic regression. MTA...... was visually scored for the left and right medial temporal lobe (score 0-4), and meaned. RESULTS: Mean age was 73.5 years (sd 5.1), 54% was female. Of the subjects, 15% had DM, and 70% had a history of hypertension. The likelihood of having MTA score 3 was significantly higher in subjects with DM (OR 2.9; 95...

  12. Study of intrarenal vasculature in cases of primary and secondary hypertension (by metallic impregnation technique on whole kidney section

    Mittal B

    1992-10-01

    Full Text Available Study of intrarenal vasculature was carried out by using the metallic impregnation technique on whole kidney sections in 31 [corrected] cases of (primary and secondary hypertension and 10 normal controls. Distinct patterns of intrarenal vasculature were noted in controls and in cases of hypertension. Gradual tapering of vessels, absence of tortuosity and good peripheral vascularisation were noted in controls. Abrupt tapering, tortuosity of vessels and poor peripheral vascularisation were noted in hypertensive cases. In essential hypertension moderate to severe changes of dilatation of the segmental and/or arcuate arteries was noted. The degree of dilatation was related to the level of systolic BP rather than diastolic in cases of essential hypertension. Secondary hypertension even if severe, rarely showed significant dilatation lesions. Avascular zones and conglomeration of vessels at poles was seen only in cases of pyelonephritis. This helped in distinguishing these, from cases of glomerulonephritis.

  13. Long-term prognosis after acute myocardial infarction in patients with a history of arterial hypertension. TRACE study group

    Gustafsson, F; Køber, L; Torp-Pedersen, C

    1998-01-01

    AIMS: The objective of the study was to investigate the influence of a history of arterial hypertension on long-term prognosis after an acute myocardial infarction in a representative population, and secondly to assess the impact on prognosis of left ventricular systolic function in hypertensives......%) of the patients had a history of arterial hypertension. During the time of observation 763 (50.6%) hypertensives and 2253 (43.7%) normotensives died, corresponding to a risk ratio for death in hypertensives of 1.23 (1.13-1.33, P .... CONCLUSION: A history of arterial hypertension is a moderate risk factor for mortality after an acute myocardial infarction in patients aged 65 years or less. This excess risk is present at all levels of left ventricular systolic function....

  14. Hypertension Knowledge-Level Scale (HK-LS): A Study on Development, Validity and Reliability

    Erkoc, Sultan Baliz; Isikli, Burhanettin; Metintas, Selma; Kalyoncu, Cemalettin

    2012-01-01

    This study was conducted to develop a scale to measure knowledge about hypertension among Turkish adults. The Hypertension Knowledge-Level Scale (HK-LS) was generated based on content, face, and construct validity, internal consistency, test re-test reliability, and discriminative validity procedures. The final scale had 22 items with six sub-dimensions. The scale was applied to 457 individuals aged ≥18 years, and 414 of them were re-evaluated for test-retest reliability. The six sub-dimensio...

  15. PM2.5 and Diabetes and Hypertension Incidence in the Black Women's Health Study.

    Coogan, Patricia F; White, Laura F; Yu, Jeffrey; Burnett, Richard T; Seto, Edmund; Brook, Robert D; Palmer, Julie R; Rosenberg, Lynn; Jerrett, Michael

    2016-03-01

    Clinical studies have shown that exposure to fine particulate matter (PM2.5) can increase insulin resistance and blood pressure. The epidemiologic evidence for an association of PM2.5 exposure with the incidence of type 2 diabetes or hypertension is inconsistent. Even a modest association would have great public health importance given the ubiquity of exposure and high prevalence of the conditions. We used Cox proportional hazards models to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for incident type 2 diabetes and hypertension associated with exposure to PM2.5 in a large cohort of African American women living in 56 metropolitan areas across the US, using data from the Black Women's Health Study. Pollutant levels were estimated at all residential locations over follow-up with a hybrid model incorporating land use regression and Bayesian Maximum Entropy techniques. During 1995 to 2011, 4,387 cases of diabetes and 9,570 cases of hypertension occurred. In models controlling for age, questionnaire cycle, and metro area, there were positive associations with diabetes (HR = 1.13, 95% CI = 1.04, 1.24) and hypertension (HR = 1.06, 95% CI = 1.00, 1.12) per interquartile range of PM2.5 (2.9 μg/m). Multivariable HRs, however, were 0.99 (95% CI = 0.90, 1.09) for diabetes and 0.99 (95% CI = 0.93, 1.06) for hypertension. Our results provide little support for an association of PM2.5 with diabetes or hypertension incidence.

  16. Effects of hypertension and ovariectomy on rat hepatocytes. Are amlodipine and lacidipine protective? (A stereological and histological study).

    Dursun, Hakan; Albayrak, Fatih; Uyanik, Abdullah; Keleş, Nuri Osman; Beyzagül, Polat; Bayram, Ednan; Halici, Zekai; Altunkaynak, Zuhal Berrin; Süleyman, Halis; Okçu, Nihat; Ünal, Bünyamin

    2010-12-01

    Calcium channel blockers are increasingly used for the treatment of hypertension. Menopause and hypertension are both important risk factors for liver damage and several other circulatory abnormalities. The aim of this study was to determine the effects of amlodipine and lacidipine in an ovariectomy-induced postmenopausal period model and a deoxycorticosterone acetate-salt-induced hypertensive model in rats. In this study, animals were divided into six groups as follows: control (Group 1), hypertension (Group 2), ovariectomy (Group 3), ovariectomy and hypertension (Group 4), ovariectomy, hypertension and amlodipine-treated (Group 5), and ovariectomy, hypertension and lacidipine-treated (Group 6). At the end of the experiment, the livers were removed and tissue samples were histologically and stereologically examined. The numerical densities of the hepatocytes according to group were 0.000422, 0.00329, 0.000272, 0.00259, 0.00374 and 0.000346 μm3, respectively. Significant differences were found between values of all groups (phypertension in Groups 5 and 6. Our experimental results show that both hypertension and the postmenopausal period have negative effects on the number of hepatocytes and histological structure of the liver. Both amlodipine and lacidipine appear to ameliorate the hypertension and/or postmenopausal period-related decrease in hepatocyte number. We thus suggest that lacidipine and particularly amlodipine have important protective and recovering effects on the liver.

  17. Target blood pressure for treatment of isolated systolic hypertension in the elderly: valsartan in elderly isolated systolic hypertension study.

    Ogihara, Toshio; Saruta, Takao; Rakugi, Hiromi; Matsuoka, Hiroaki; Shimamoto, Kazuaki; Shimada, Kazuyuki; Imai, Yutaka; Kikuchi, Kenjiro; Ito, Sadayoshi; Eto, Tanenao; Kimura, Genjiro; Imaizumi, Tsutomu; Takishita, Shuichi; Ueshima, Hirotsugu

    2010-08-01

    In this prospective, randomized, open-label, blinded end point study, we aimed to establish whether strict blood pressure control ( or =140 mm Hg to or =2 years. The strict control (1545 patients) and moderate control (1534 patients) groups were well matched (mean age: 76.1 years; mean blood pressure: 169.5/81.5 mm Hg). Median follow-up was 3.07 years. At 3 years, blood pressure reached 136.6/74.8 mm Hg and 142.0/76.5 mm Hg, respectively. The blood pressure difference between the 2 groups was 5.4/1.7 mm Hg. The overall rate of the primary composite end point was 10.6 per 1000 patient-years in the strict control group and 12.0 per 1000 patient-years in the moderate control group (hazard ratio: 0.89; [95% CI: 0.60 to 1.34]; P=0.38). In summary, blood pressure targets of or = 70 years of age with isolated systolic hypertension, although our trial was underpowered to definitively determine whether strict control was superior to less stringent blood pressure targets.

  18. A STUDY OF THE ANTIOXIDANT EFFECTS OF IRANIAN CAPTOPRIL ON PATIENTS WITH HYPERTENSION AND HEART FAILURE

    Sedighe Asgari

    2010-12-01

    Full Text Available Abstract INTRODUCTION: Myocardial ischemia, cerebral ischemia and myocardial infarction are the most important complications of hypertension and atherosclerotic disease in developing countries. Angiotensin converting enzyme (ACE inhibitors are among the drugs used to treat hypertension and heart failure. Captopril is an ACE-inhibitor which also has antioxidant properties. This study was conducted to assess the antioxidant effects of Iranian Captopril on malondialdehyde (MDA, conjugated dienes (CD and serum antioxidant capacity before and after treatment. methods: This interventional prospective single-blind study was conducted on 34 mildly hypertensive individuals and 34 patients with stage I and II heart failure. MDA, CD and serum antioxidant capacity were measured in all samples. The patients were then given 50 mg Captopril tablets 2-3 times daily. The measurements were repeated 1.5 months later. results: Comparison of mean MDA, CD and serum antioxidant capacity in hypertensive patients and patients with heart failure before and after drug administration revealed no significant difference in any of the parameters studied. Discussion: Existing evidence is suggestive of the strong antioxidative properties of Captopril in vitro, although these effects have not been borne out by some studies. In the present study, comparison of MDA, CD and serum antioxidants before and after the period of treatment with Iranian Captopril did not reveal any statistically significant difference.Keywords • Antioxidant • ACE inhibitor • High blood pressure • Heart failure • Clinical trial

  19. CADIOVASCULAR HEALTH AND INCIDENT HYPERTENSION IN AFRICAN AMERICANS: THE JACKSON HEART STUDY

    Booth, John N.; Abdalla, Marwah; Tanner, Rikki M.; Diaz, Keith M.; Bromfield, Samantha G.; Tajeu, Gabriel S.; Correa, Adolfo; Sims, Mario; Ogedegbe, Gbenga; Bress, Adam P.; Spruill, Tanya M.; Shimbo, Daichi; Muntner, Paul

    2018-01-01

    Several modifiable health behaviors and health factors that comprise the Life’s Simple 7, a cardiovascular health metric, have been associated with hypertension risk. We determined the association between cardiovascular health and incident hypertension in the Jackson Heart Study, a cohort of African-Americans. We analyzed participants without hypertension or cardiovascular disease at baseline (2000–2004) who attended ≥1 follow-up visit in 2005–2008 or 2009–2012 (n=1878). Body mass index, physical activity, diet, cigarette smoking, blood pressure, total cholesterol and fasting glucose were assessed at baseline and categorized as ideal, intermediate or poor using the American Heart Association’s Life’s Simple 7 definitions. Incident hypertension was defined at the first visit wherein a participant had systolic blood pressure≥140 mmHg, diastolic blood pressure≥90 mmHg or self-reported taking antihypertensive medication. There percentage of participants with ≤1, 2, 3, 4, 5 and 6 ideal Life’s Simple 7 components was 6.5%, 22.4%, 34.4%, 25.2%, 10.0% and 1.4%, respectively. No participants had 7 ideal components. During follow-up (median: 8.0 years), 944 (50.3%) participants developed hypertension, including 81.3% with ≤1 and 11.1% with 6 ideal components. The multivariable-adjusted hazard ratios (95% confidence interval) for incident hypertension comparing participants with 2, 3, 4, 5 and 6 versus ≤1 ideal component were 0.80 (0.61–1.03), 0.58 (0.45–0.74), 0.30 (0.23–0.40), 0.26 (0.18–0.37) and 0.10 (0.03–0.31), respectively (p-trendhypertension risk. PMID:28652461

  20. Sex differences in the risk profile of hypertension: a cross-sectional study.

    Ghosh, Saswata; Mukhopadhyay, Simantini; Barik, Anamitra

    2016-07-27

    To assess the socioeconomic and behavioural risk factors associated with hypertension among a sample male and female population in India. Cross-sectional survey data from a Health and Demographic Surveillance System (HDSS) of rural West Bengal, India was used. 27 589 adult individuals (13 994 males and 13 595 females), aged ≥18 years, were included in the study. Hypertension was defined as mean systolic blood pressure (SBP) ≥140 mm Hg or diastolic blood pressure (DBP) ≥90 mm Hg, or if the subject was undergoing regular antihypertensive therapy. Prehypertension was defined as SBP 120-139 mm Hg and DBP 80-89 mm Hg. Individuals were categorised as non-normotensives, which includes both the prehypertensives and hypertensives. Generalised ordered logit model (GOLM) was deployed to fulfil the study objective. Over 39% of the men and 25% of the women were prehypertensives. Almost 12.5% of the men and 11.3% of the women were diagnosed as hypertensives. Women were less likely to be non-normotensive compared to males. Odds ratios estimated from GOLM indicate that women were less likely to be hypertensive or prehypertensive, and age (OR 1.04, 95% CI 1.03 to 1.05; and OR 1.08, 95% CI 1.07 to 1.09 for males and females, respectively) and body mass index (OR 1.64, 95% CI 1.38 to 1.97 for males; and OR 1.32, 95% CI 1.08 to 1.60 for females) are associated with hypertension. An elevated level of hypertension exists among a select group of the rural Indian population. Focusing on men, an intervention could be designed for lifestyle modification to curb the prevalence of hypertension. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  1. Sex differences in the medication choice for hypertension in general practice. A study with written case simulations

    Klungel, O.H.; Paes, A.H.P.; de Boer, A; Kuyvenhoven, M.; Seidell, J C; Bakker, A

    The objective of this study was to explore explanations for the preference of physicians to prescribe beta-blockers to hypertensive men and diuretics to hypertensive women. A qualitative study among 12 family physicians was conducted with a combination of written case simulations, semi-structured

  2. Prevalence of renal artery stenosis in subjects with moderate hypertension. A population-based study

    Andersen, Ulrik B; Borglykke, Anders; Jørgensen, Torben

    2011-01-01

    Abstract Aim. To examine the prevalence of significant renal artery stenosis (RAS) in subjects with moderate to severe hypertension. Materials and methods. Subjects aged 50-66 years with blood pressure >160/100 mmHg or receiving antihypertensive treatment were selected from the population study...

  3. Safety of telmisartan in patients with arterial hypertension - An open-label observational study

    Michel, Martin C.; Bohner, Herbert; Köster, Jürgen; Schäfers, Rafael; Heemann, Uwe

    2004-01-01

    Objective: To determine whether age, gender, concomitant disease and/or previous or present antihypertensive medication affect the safety or antihypertensive efficacy of telmisartan in the treatment of arterial hypertension. Study Design and Methods: In this large-scale, open-label postmarketing

  4. METOPROLOL VERSUS THIAZIDE DIURETICS IN HYPERTENSION - MORBIDITY RESULTS FROM THE MAPHY STUDY

    WIKSTRAND, J; WARNOLD, [No Value; TUOMILEHTO, J; OLSSON, G; BARBER, HJ; ELIASSON, K; ELMFELDT, D; JASTRUP, B; KARATZAS, NB; LEER, J; MARCHETTA, F; RAGNARSSON, J; ROBITAILLE, NM; VALKOVA, L; WESSELING, H; BERGLUND, G

    The present study in hypertensive men (40-64 years old) with untreated diastolic blood pressure above 100 mm Hg was aimed at investigating whether metoprolol (n = 1,609) given as initial treatment would lower the risk for coronary events (sudden death and myocardial infarction) more effectively than

  5. ABCC-JNIH Adult Health Study Hiroshima, 1958 to 1959. Hypertension and ischemic heart disease

    Switzer, S

    1963-11-12

    The interrelations of hypertension, ischemic heart disease, blood lipid levels and ionizing irradiation were investigated among 1051 male and 1872 female members of the ABCC-JNIH Adult Health Study. No significant effect of ionizing irradiation upon the cardiovascular system were detected. No major difference in age-sex specific mean blood pressures between Adult Health Study subjects and a suitable American comparison group was found. An accelerated course with fulminating vascular deterioration was suspected in only 1% of the hypertensive subjects. As a result, advanced retinopathy and renal failure were rarely seen. Electrocardiographic evidence of left ventricular hypertrophy occurred in 7.2% of the hypertensive subjects in this study, and was readily correlated with ambient systolic blood pressure. Evidences of ischemic heart disease and congestive failure were rare and distinctly less common than in American males unselected as to blood pressure levels. In contrast, mortality statistics indicate cerebrovascular disease to be at least as common in Japan as in the United States. Adult Health Study data exhibit low serum cholesterol concentrations by Western standards and elevated levels are predominantly limited to the obese. Both factors appear of importance in the occasional hypertensive subject with ischemic heart disease. The therapeutic implication of this observation is briefly discussed. 57 references, 10 tables.

  6. Plasma proteome analysis in patients with pulmonary arterial hypertension: an observational cohort study.

    Rhodes, Christopher J; Wharton, John; Ghataorhe, Pavandeep; Watson, Geoffrey; Girerd, Barbara; Howard, Luke S; Gibbs, J Simon R; Condliffe, Robin; Elliot, Charles A; Kiely, David G; Simonneau, Gerald; Montani, David; Sitbon, Olivier; Gall, Henning; Schermuly, Ralph T; Ghofrani, H Ardeschir; Lawrie, Allan; Humbert, Marc; Wilkins, Martin R

    2017-09-01

    Idiopathic and heritable pulmonary arterial hypertension form a rare but molecularly heterogeneous disease group. We aimed to measure and validate differences in plasma concentrations of proteins that are associated with survival in patients with idiopathic or heritable pulmonary arterial hypertension to improve risk stratification. In this observational cohort study, we enrolled patients with idiopathic or heritable pulmonary arterial hypertension from London (UK; cohorts 1 and 2), Giessen (Germany; cohort 3), and Paris (France; cohort 4). Blood samples were collected at routine clinical appointment visits, clinical data were collected within 30 days of blood sampling, and biochemical data were collected within 7 days of blood sampling. We used an aptamer-based assay of 1129 plasma proteins, and patient clinical details were concealed to the technicians. We identified a panel of prognostic proteins, confirmed with alternative targeted assays, which we evaluated against the established prognostic risk equation for pulmonary arterial hypertension derived from the REVEAL registry. All-cause mortality was the primary endpoint. 20 proteins differentiated survivors and non-survivors in 143 consecutive patients with idiopathic or heritable pulmonary arterial hypertension with 2 years' follow-up (cohort 1) and in a further 75 patients with 2·5 years' follow-up (cohort 2). Nine proteins were both prognostic independent of plasma NT-proBNP concentrations and confirmed by targeted assays. The functions of these proteins relate to myocardial stress, inflammation, pulmonary vascular cellular dysfunction and structural dysregulation, iron status, and coagulation. A cutoff-based score using the panel of nine proteins provided prognostic information independent of the REVEAL equation, improving the C statistic from area under the curve 0·83 (for REVEAL risk score, 95% CI 0·77-0·89; parterial hypertension in cohort 3 (p=0·0133). The protein panel was validated in 93 patients

  7. Work-related maternal risk factors and the risk of pregnancy induced hypertension and Preeclampsia during pregnancy. The generation R study

    J.J. Nugteren (Jaap); C.A. Snijder (Claudia); A. Hofman (Albert); V.W.V. Jaddoe (Vincent); E.A.P. Steegers (Eric); A. Burdorf (Alex)

    2012-01-01

    textabstractObjective: To study the associations between physically demanding work and occupational exposure to chemicals and hypertensive disorders during pregnancy within a large birth cohort study, the Generation R Study. Methods: Associations between occupational characteristics and hypertensive

  8. Hemodynamic Effects of Phenylephrine, Vasopressin, and Epinephrine in Children With Pulmonary Hypertension: A Pilot Study.

    Siehr, Stephanie L; Feinstein, Jeffrey A; Yang, Weiguang; Peng, Lynn F; Ogawa, Michelle T; Ramamoorthy, Chandra

    2016-05-01

    During a pulmonary hypertensive crisis, the marked increase in pulmonary vascular resistance can result in acute right ventricular failure and death. Currently, there are no therapeutic guidelines for managing an acute crisis. This pilot study examined the hemodynamic effects of phenylephrine, arginine vasopressin, and epinephrine in pediatric patients with pulmonary hypertension. In this prospective, open-label, nonrandomized pilot study, we enrolled pediatric patients previously diagnosed with pulmonary hypertensive who were scheduled electively for cardiac catheterization. Primary outcome was a change in the ratio of pulmonary-to-systemic vascular resistance. Baseline hemodynamic data were collected before and after the study drug was administered. Eleven of 15 participants were women, median age was 9.2 years (range, 1.7-14.9 yr), and median weight was 26.8 kg (range, 8.5-55.2 kg). Baseline mean pulmonary artery pressure was 49 ± 19 mm Hg, and mean indexed pulmonary vascular resistance was 10 ± 5.4 Wood units. Etiology of pulmonary hypertensive varied, and all were on systemic pulmonary hypertensive medications. Patients 1-5 received phenylephrine 1 μg/kg; patients 6-10 received arginine vasopressin 0.03 U/kg; and patients 11-15 received epinephrine 1 μg/kg. Hemodynamics was measured continuously for up to 10 minutes following study drug administration. After study drug administration, the ratio of pulmonary-to-systemic vascular resistance decreased in three of five patients receiving phenylephrine, five of five patients receiving arginine vasopressin, and three of five patients receiving epinephrine. Although all three medications resulted in an increase in aortic pressure, only arginine vasopressin consistently resulted in a decrease in the ratio of systolic pulmonary artery-to-aortic pressure. This prospective pilot study of phenylephrine, arginine vasopressin, and epinephrine in pediatric patients with pulmonary hypertensive showed an increase in aortic

  9. Long-term renal outcome in patients with malignant hypertension: a retrospective cohort study

    Amraoui, Fouad; Bos, Sarah; Vogt, Liffert; van den Born, Bert-Jan

    2012-01-01

    Background: Malignant hypertension is frequently complicated by renal insufficiency. Although the survival of this hypertensive emergency has improved, recent data on renal outcome and its predictors are lacking. We assessed renal outcome and its predictors in patients with malignant hypertension.

  10. Prevalence of Hypertension in Professional Drivers (from the RACER-ABPM Study).

    Platek, Anna E; Szymanski, Filip M; Filipiak, Krzysztof J; Kotkowski, Marcin; Rys, Anna; Semczuk-Kaczmarek, Karolina; Adamkiewicz, Karolina

    2017-11-15

    Professional drivers are a group exposed to many cardiovascular risk factors. Nonsystematic working hours, stress, low physical activity, and unhealthy dietary habits are common among professional drivers. These translate into high risk of cardiovascular disease. The aim of the current analysis was to establish the prevalence of arterial hypertension in a group of continuous professional drivers. The RACER (Risk of Adverse Cardiovascular Events among professional dRivers in Poland) study is a prospective study focused on assessing cardiovascular risk factors in professional drivers. Patients included in the study were screened for the classical and nonclassical cardiovascular risk factors and had an ambulatory blood pressure monitoring (ABPM) performed. Of the RACER study population, 144 drivers were included into the RACER-ABPM study. Of this group 135 (95.7%) were male at mean age of 50.2 ± 9.3 years, with mean body mass index of 32.3 ± 3.0 kg/m 2 . In 21.3% of patients, family history of cardiovascular disease was noted, 28.1% were current smokers, and 2.9% had diabetes mellitus. Arterial hypertension was previously diagnosed in 39 patients (27.9%). In ABPM, the mean 24-hour blood pressure (BP) values were 130.3 ± 14.3 and 80.9 ± 9.9 for systolic and diastolic BP, respectively, and 46.1% of patients could be categorized as dippers. Based on the ABPM results, arterial hypertension was diagnosed in 104 of patients (73.8%). Patients with hypertension tend to be more often male and have a family history of cardiovascular disease. In conclusion, arterial hypertension is highly prevalent in professional drivers. Also abnormal day-to-night BP value patterns are often seen in this group. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Association between Anthropometric Measures and Indicators for Hypertension Control among Kazakh-Chinese Hypertension Patients in Xinjiang, China: Results from a Cross-sectional Study.

    Qinghua Zhang

    Full Text Available Among Kazakh-Chinese population in Xinjiang province of China, prevalence of obesity and hypertension were 40.1% and 50.3% respectively, the highest across all ethnic groups residing in this pastureland. Despite this, there remained a dearth of information regarding the association between the anthropometric measures [body mass index (BMI, waist circumference (WC, waist-hip ratio (WHR, Waist-to-height ratio (WHtR etc.] and indicators for hypertension control [achieved levels of systolic and diastolic blood pressures (SBP and DBP, pulse pressure index (PPI, ankle-brachial index (ABI etc.] among them.A cross-sectional study was conducted in Xinjiang to determine the distribution and inter-relationships of the anthropometric measures and indicators for achieved BP control as well as their predictors among hypertension patients of Kazakh-Chinese ethnicity. Out of 550 randomly selected patients, 516 completed the interview, anthropometry and BP assessments.In the sample population, average SBP, DBP and PP were 156.26±24.40mmHg, 87.55±14.73mmHg and 68.71±19.39mmHg respectively. Bivariate analysis identified age, gender, education, duration of hypertension, WC and BMI being factors influencing the achieved levels of BP. Adjusted multiple linear regression models elicited positive associations of age (βa = 0.152, p = 0.001 and duration of hypertension (βa = 0.132, p = 0.003 with achieved level of SBP as well as BMI (βa = 0.135, p = 0.002 with DBP. Age (βa = 0.207, p<0.001 and WHtR (βa = 0.304, p = 0.005 were positively and WC (βa = -0.406, p<0.001 was negatively associated with PPI. Increasing age (βa = -0.125, p = 0.005, female gender (βa = -0.122, p = 0.005 and 5years' duration of hypertension (βa = -0.091, p<0.039 were negatively associated with ABI. After adjustment for socio-demographic variables, hypertensive patients with (reference = without abdominal obesity had 93% (p = 0.013 higher odds of missing the target BP control

  12. Estimation of Hypertension Risk from Lifestyle Factors and Health Profile: A Case Study

    Zhuoyuan Zheng

    2014-01-01

    Full Text Available Hypertension is a highly prevalent risk factor for cardiovascular disease and it can also lead to other diseases which seriously harm the human health. Screening the risks and finding a clinical model for estimating the risk of onset, maintenance, or the prognosis of hypertension are of great importance to the prevention or treatment of the disease, especially if the indicator can be derived from simple health profile. In this study, we investigate a chronic disease questionnaire data set of 6563 rural citizens in East China and find out a clinical signature that can assess the risk of hypertension easily and accurately. The signature achieves an accuracy of about 83% on the external test dataset, with an AUC of 0.91. Our study demonstrates that a combination of simple lifestyle features can sufficiently reflect the risk of hypertension onset. This finding provides potential guidance for disease prevention and control as well as development of home care and home-care technologies.

  13. Hypertension and hypertension-related disease in Mongolia; findings of a national knowledge, attitudes and practices study

    Demaio, Alessandro R; Otgontuya, Dugee; de Courten, Maximilian

    2013-01-01

    Mongolia has a high and increasing burden of hypertension and related disease, with cardiovascular diseases among the leading causes of death. Yet little is known about the knowledge, attitudes and practices of the Mongolian population with regards to blood pressure. With this in mind, a national...

  14. Prevalence and determinants of hypertension in Myanmar - a nationwide cross-sectional study.

    Bjertness, Marius B; Htet, Aung Soe; Meyer, Haakon E; Htike, Maung Maung Than; Zaw, Ko Ko; Oo, Win Myint; Latt, Tint Swe; Sherpa, Lhamo Y; Bjertness, Espen

    2016-07-18

    Non-communicable diseases (NCDs), malaria and tuberculosis dominate the disease pattern in Myanmar. Due to urbanization, westernized lifestyle and economic development, it is likely that NCDs such as cerebrovascular disease and ischemic heart disease are on a rise. The leading behavioral- and metabolic NCDs risk factors are tobacco smoke, dietary risks and alcohol use, and high blood pressure and body mass index, respectively. The study aimed at estimating the prevalence and determinants of hypertension, including metabolic-, behavioral- and socio-demographic risk factors. A nationwide, cross-sectional study of 7429 citizens of Myanmar aged 15-64 years were examined in 2009, using the WHO STEPS methodology. In separate analyses by gender, odds radios (ORs) and 95 % confidence intervals (CIs) for determinants of hypertension were estimated using logistic regression analyses. Confounders included in analyses were chosen based on Directed acyclic graphs (DAGs). The prevalence of hypertension was 30.1 % (95 % CI: 28.4-31.8) in males and 29.8 % (28.5-31.1) in females. The mean BMI was 21.7 (SD 4.3) kg/m(2) for males and 23.0 (5.1) kg/m(2) for females. In fully adjusted analyses, we found in both genders increased OR for hypertension if the participants had high BMI (males: OR = 2.6; 95 % CI 2.1-3.3, females: OR = 2.3; 2.0-2.7) and high waist circumference (males: OR = 3.4; 1.8-6.8, females: OR = 2.7; 2.2-3.3). In both sexes, associations were also found between hypertension and low physical activity at work, or living in urban areas or the delta region. Being underweight and use of sesame oil in cooking was associated with lower odds for hypertension. The prevalence of hypertension was high and associated with metabolic-, behavioral- and socio-demographic factors. Due to expected rapid economic growth in Myanmar we recommend similar studies in the future to follow up and describe trends in the risk factors, especially modifiable factors, which will

  15. Prevalence and determinants of hypertension in Myanmar - a nationwide cross-sectional study

    Marius B. Bjertness

    2016-07-01

    Full Text Available Abstract Background Non-communicable diseases (NCDs, malaria and tuberculosis dominate the disease pattern in Myanmar. Due to urbanization, westernized lifestyle and economic development, it is likely that NCDs such as cerebrovascular disease and ischemic heart disease are on a rise. The leading behavioral- and metabolic NCDs risk factors are tobacco smoke, dietary risks and alcohol use, and high blood pressure and body mass index, respectively. The study aimed at estimating the prevalence and determinants of hypertension, including metabolic-, behavioral- and socio-demographic risk factors. Methods A nationwide, cross-sectional study of 7429 citizens of Myanmar aged 15–64 years were examined in 2009, using the WHO STEPS methodology. In separate analyses by gender, odds radios (ORs and 95 % confidence intervals (CIs for determinants of hypertension were estimated using logistic regression analyses. Confounders included in analyses were chosen based on Directed acyclic graphs (DAGs. Results The prevalence of hypertension was 30.1 % (95 % CI: 28.4–31.8 in males and 29.8 % (28.5–31.1 in females. The mean BMI was 21.7 (SD 4.3 kg/m2 for males and 23.0 (5.1 kg/m2 for females. In fully adjusted analyses, we found in both genders increased OR for hypertension if the participants had high BMI (males: OR = 2.6; 95 % CI 2.1–3.3, females: OR = 2.3; 2.0–2.7 and high waist circumference (males: OR = 3.4; 1.8–6.8, females: OR = 2.7; 2.2–3.3. In both sexes, associations were also found between hypertension and low physical activity at work, or living in urban areas or the delta region. Being underweight and use of sesame oil in cooking was associated with lower odds for hypertension. Conclusions The prevalence of hypertension was high and associated with metabolic-, behavioral- and socio-demographic factors. Due to expected rapid economic growth in Myanmar we recommend similar studies in the future to follow up and describe

  16. Frequency and co-prescription pattern of Chinese herbal products for hypertension in Taiwan: a Cohort study.

    Yang, Pei-Rung; Shih, Wei-Tai; Chu, Yen-Hua; Chen, Pau-Chung; Wu, Ching-Yuan

    2015-06-06

    Chinese herbal products (CHPs) have been frequently used among patients with chronic diseases including hypertension; however, the co-prescription pattern of herbal formulae and single herbs remain uncharacterized. Thus, this large-scale pharmacoepidemiological study evaluated the frequency and co-prescription pattern of CHPs for treating hypertension in Taiwan from 2003 to 2009. The database of traditional Chinese medicine (TCM) outpatient claims was obtained from the National Health Insurance in Taiwan. Patients with hypertension during study period were defined according to diagnostic codes in the International Classification of Disease Ninth Revision, Clinical Modification. The frequencies and percentages of herbal formula and single herb prescriptions for hypertension were analyzed. We also applied association rules to evaluate the CHPs co-prescription patterns. The hypertension cohort included 154,083 patients, 123,240 patients of which (approximately 80 %) had used TCM at least once. In total, 81,582 visits involving CHP prescriptions were hypertension related; Tian-Ma-Gou-Teng-Yin and Dan Shen (Radix Salvia Miltiorrhizae) were the most frequently prescribed herbal formula and single herb, respectively, for treating hypertension. This study elucidated the utilization pattern of CHPs for treating hypertension. Future studies on the efficacy and safety of these CHPs and on drug-herb interactions are warranted.

  17. Salt intake, obesity, and pre-hypertension among Iranian adults: a cross-sectional study

    Khosravi, A.; Toghianifar, N.; Sarrafzodegan, N

    2012-01-01

    Objective: Overweight and obese subjects are prone to have a high salt intake. This study was aimed to investigate the relationship between salt intake and pre hypertension among overweight and obese subjects. Methodology: This was across-sectional study performed in the setting of a community-based intervention: the Isfahan Healthy Heart Program (IHHP). In total, 806 subjects with normal blood pressure or pre hypertension entered the study. Salt intake, BMI, and blood pressure were measured using standard methods. Results: The salt intake was 9.19 +- 5.34, 11.6 6.87, and 11.64 +- 6.68 gm/d in normal-weight, overweight and obese subjects with normal blood pressure, respectively (p=0.0001). The values for normal-weight, overweight and obese pre hypertensive subjects were 12.04 +- 8.03, 12.41 +- 6.45, and 12.52+- 7.63 gm/d, respectively (p=0.236). The unadjusted odds ratio for pre hypertension among obese subjects was 4.78 (95% Cl: 2.38 - 9.60). The odds ratio was 4.73 (95% CI 2.19-10.19), 4.65 (95%CI 2.15-10.05), and 3.37 (95%CI 1.45-7.85) after adjustment for socio demographic characteristics, lifestyle factors, and salt intake, respectively. An increase of one gram per day in the daily salt intake increased the probability of having pre hypertension by 5% after adjusting for age, education, BMI, and lifestyle factors. Conclusion: The findings of this study support a role for high salt intake in the high blood pressure of overweight and obese subjects. (author)

  18. Prenatal Exposure to the Pesticide DDT and Hypertension Diagnosed in Women before Age 50: A Longitudinal Birth Cohort Study

    Cirillo, Piera M.; Terry, Mary Beth; Krigbaum, Nickilou Y.; Flom, Julie D.; Cohn, Barbara A.

    2013-01-01

    Background: Elevated levels of the pesticide DDT (dichlorodiphenyltrichloroethane) have been positively associated with blood pressure and hypertension in studies among adults. Accumulating epidemiologic and toxicologic evidence suggests that hypertension during adulthood may also be affected by earlier life and possibly the prenatal environment. Objectives: We assessed whether prenatal exposure to the pesticide DDT increases risk of adult hypertension. Methods: We examined concentrations of DDT (p,p´- and o,p´-) and its metabolite p,p´-DDE (dichlorodiphenyldichloroethylene) in prenatal serum samples from a subset of women (n = 527) who had participated in the prospective Child Health and Development Studies birth cohort in the San Francisco Bay area while they were pregnant between 1959 and 1967. We surveyed daughters 39–47 years of age by telephone interview from 2005 to 2008 to obtain information on self-reported physician-diagnosed hypertension and use of hypertensive medication. We used multivariable regression analysis of time to hypertension based on the Cox proportional hazards model to estimate relative rates for the association between prenatal DDT exposures and hypertension treated with medication in adulthood, with adjustment for potential confounding by maternal, early-life, and adult exposures. Results: Prenatal p,p´-DDT exposure was associated with hypertension [adjusted hazard ratio (aHR) = 3.6; 95% CI: 1.8, 7.2 and aHR = 2.5; 95% CI: 1.2, 5.3 for middle and high tertiles of p,p´-DDT relative to the lowest tertile, respectively]. These associations between p,p´-DDT and hypertension were robust to adjustment for independent hypertension risk factors as well as sensitivity analyses. Conclusions: These findings suggest that the association between DDT exposure and hypertension may have its origins early in development. PMID:23591545

  19. Family clustering of secondary chronic kidney disease with hypertension or diabetes mellitus. A case-control study.

    de Almeida, Fernando Antonio; Ciambelli, Giuliano Serafino; Bertoco, André Luz; Jurado, Marcelo Mai; Siqueira, Guilherme Vasconcelos; Bernardo, Eder Augusto; Pavan, Maria Valeria; Gianini, Reinaldo José

    2015-02-01

    In Brazil hypertension and type 2 diabetes mellitus are responsible for 60% of cases of end-stage renal disease in renal replacement therapy. In the United States studies have identified family clustering of chronic kidney disease, predominantly in African-Americans. A single Brazilian study observed family clustering among patients with chronic kidney disease when compared with hospitalized patients with normal renal function. This article aims to assess whether there is family clustering of chronic kidney disease in relatives of individuals in renal replacement therapy caused by hypertension and/or diabetes mellitus. A case-control study with 336 patients in renal replacement therapy with diabetes mellitus or hypertension for at least 5 years (cases) and a control matched sample group of individuals with hypertension or diabetes mellitus and normal renal function (n = 389). Individuals in renal replacement therapy (cases) had a ratio of 2.35 (95% CI 1.42-3.89, p hypertension or diabetes mellitus).

  20. Association of blood glucose level and hypertension in Elderly Chinese Subjects: a community based study.

    Yan, Qun; Sun, Dongmei; Li, Xu; Chen, Guoliang; Zheng, Qinghu; Li, Lun; Gu, Chenhong; Feng, Bo

    2016-07-13

    There is a scarcity of epidemiological researches examining the relationship between blood pressure (BP) and glucose level among older adults. The objective of the current study was to investigate the association of high BP and glucose level in elderly Chinese. A cross-sectional study of a population of 2092 Chinese individuals aged over 65 years was conducted. Multiple logistic analysis was used to explore the association between hypertension and hyperglycemia. Independent risk factors for systolic and diastolic BP were analyzed using stepwise linear regression. Subjects in impaired fasting glucose group (IFG) (n = 144) and diabetes (n = 346), as compared with normal fasting glucose (NFG) (n = 1277), had a significant higher risk for hypertension, with odds ratios (ORs) of 1.81 (95 % CI, 1.39-2.35) (P = 0.000) and 1.40 (95 % CI, 1.09-1.80) (P = 0.009), respectively. Higher fasting plasma glucose (FPG) levels in the normal range were still significantly associated with a higher prevalence of hypertension in both genders, with ORs of 1.24 (95 % CI, 0.85-1.80), R (2) = 0.114, P = 0.023 in men and 1.61 (95 % CI, 1.12-2.30), R (2) = 0.082, P = 0.010 in women, respectively, when compared with lower FPG. Linear regression analysis revealed FPG was an independent factor of systolic and diastolic BP. Our findings suggest that hyperglycemia as well as higher FPG within the normal range is associated with a higher prevalence of hypertension independent of other cardiovascular risk factors in elderly Chinese. Further studies are needed to explore the relationship between hyperglycemia and hypertension in a longitudinal setting.

  1. Plasma ET-1 Concentrations Are Elevated in Pregnant Women with Hypertension -Meta-Analysis of Clinical Studies

    Yong-Ping Lu

    2017-11-01

    Full Text Available Background/Aims: The ET system might be involved in the pathogenesis of hypertensive disorders during pregnancy. The objective is to analyse the impact of ET-1 in hypertensive pregnant women by a strict meta-analysis of published human clinical studies. Methods: Based on the principle of Cochrane systematic reviews, Cohort studies in PubMed (Medline, Google Scholar and China Biological Medicine Database (CBM-disc designed to identify the role of endothelin-1 (ET-1 in the pathophysiology of gestational hypertension and preeclampsia were screened. Review Manager Version 5.0 (Rev-Man 5.0 was applied for statistical analysis. Mean difference and 95% confidence interval (CI were shown in inverse variance (IV fixed-effects model or IV random-effects model. Results: Sixteen published cohort studies including 1739 hypertensive cases and 409 controls were used in the meta-analysis. ET-1 plasma concentrations were higher in hypertensive pregnant women as compared to the controls (mean difference between groups: 19.02 [15.60~22.44], P < 0.00001,. These finding were driven by severity of hypertension and/or degree of proteinuria. Conclusion: Plasma ET-1 concentrations are elevated in hypertensive disorders during human pregnancy. In particular women with preeclampsia (hypertensive pregnant women with proteinuria have substantially elevated plasma ET-1 concentration as compared to pregnant women with normal blood pressure.

  2. Systolic hypertension in adult nigerians with hypertension

    Opadijo, O.G.; Salami, T.A.T.; Sanya, E.O.; Omotoso, A.B.O.

    2007-01-01

    To determine the prevalence of both systolic and diastolic hypertensions in relation to age and their impacts on target organ among adult Nigerians with hypertension. Newly diagnosed adult hypertensives, with blood pressure 140/90mm Hg, taken twice with mercury column sphygmomanometer at 3 weeks interval, were studied. The total number of hypertensive patients treated over this period was also taken into consideration. The newly diagnosed hypertensives were classified using JNC VI classification. The frequency of occurrence of target organ damage such as Left Ventricular Hypertrophy (LVH), heart failure, renal impairment etc. was charted according to systolic and or diastolic pressures. The occurrence of systolic or diastolic blood pressure was also related with the age of the patients. Blood metabolic parameters were compared in both systolic and diastolic blood pressures for their possible contributory role. Two thousand seven hundred and ninety-two adult hypertensive patients were managed over the study period. Of them, 218 (7.8%) were newly diagnosed and studied. There were 94 males and 124 females. Seventy-seven (35.3%) were aged 60 years and above with equal frequency in the gender. One hundred and seventy-eight (81.7%) cases had combined systolic and diastolic pressures. Twenty-nine (13.3%) patients had systolic hypertension. Twenty-five (86.2%) of these 29 were aged 50 years and above and 20 (69.0%) were aged 60 years and above. Eleven (5.0%) patients had isolated diastolic hypertension and they were all in the age bracket 40-49 years. Systolic blood pressure was found to be rising with advancing age while diastolic blood pressure peaked at mid 40's and declined. Target organ damage occurred more frequently with systolic hypertension and advancing age than with diastolic hypertension. Systolic hypertension occurred more frequently in this series of adult Nigerians with hypertension. It was higher with advancing age and associated with more target organ

  3. Positional change in blood pressure and 8-year risk of hypertension: the CARDIA Study.

    Thomas, Randal J; Liu, Kiang; Jacobs, David R; Bild, Diane E; Kiefe, Catarina I; Hulley, Stephen B

    2003-08-01

    To assess the relationship between positional blood pressure change and 8-year incidence of hypertension in a biracial cohort of young adults. Participants from the Coronary Artery Risk Development in Young Adults (CARDIA) study with complete data from year 2 (1987-1988), year 5 (1990-1991), year 7 (1992-1993), and year 10 (1995-1996) examinations were included (N = 2781). Participants were classified into 3 groups based on their year 2 systolic blood pressure response to standing: drop, a decrease in systolic blood pressure of more than 5 mm Hg; same, a change of between -5 and +5 mm Hg; and rise, more than 5-mm Hg increase. The number of participants in each group was as follows: drop, 741; same, 1590; and rise, 450. The 8-year incidence of hypertension was 8.4% in the drop group, 6.8% in the same group, and 12.4% in the rise group (P women, 2.47 (95% CI, 1.19-5.11), in white men, 2.17 (95% CI, 1.00-4.73), and in white women, 4.74 (95% CI, 1.11-20.30). A greater than 5-mm Hg increase in blood pressure on standing identified a group of young adults at increased risk of developing hypertension within 8 years. These findings support a physiologic link between sympathetic nervous system reactivity and risk of hypertension in young adults.

  4. Hypertension Knowledge-Level Scale (HK-LS: A Study on Development, Validity and Reliability

    Cemalettin Kalyoncu

    2012-03-01

    Full Text Available This study was conducted to develop a scale to measure knowledge about hypertension among Turkish adults. The Hypertension Knowledge-Level Scale (HK-LS was generated based on content, face, and construct validity, internal consistency, test re-test reliability, and discriminative validity procedures. The final scale had 22 items with six sub-dimensions. The scale was applied to 457 individuals aged ≥18 years, and 414 of them were re-evaluated for test-retest reliability. The six sub-dimensions encompassed 60.3% of the total variance. Cronbach alpha coefficients were 0.82 for the entire scale and 0.92, 0.59, 0.67, 0.77, 0.72, and 0.76 for the sub-dimensions of definition, medical treatment, drug compliance, lifestyle, diet, and complications, respectively. The scale ensured internal consistency in reliability and construct validity, as well as stability over time. Significant relationships were found between knowledge score and age, gender, educational level, and history of hypertension of the participants. No correlation was found between knowledge score and working at an income-generating job. The present scale, developed to measure the knowledge level of hypertension among Turkish adults, was found to be valid and reliable.

  5. Hypertension Knowledge-Level Scale (HK-LS): a study on development, validity and reliability.

    Erkoc, Sultan Baliz; Isikli, Burhanettin; Metintas, Selma; Kalyoncu, Cemalettin

    2012-03-01

    This study was conducted to develop a scale to measure knowledge about hypertension among Turkish adults. The Hypertension Knowledge-Level Scale (HK-LS) was generated based on content, face, and construct validity, internal consistency, test re-test reliability, and discriminative validity procedures. The final scale had 22 items with six sub-dimensions. The scale was applied to 457 individuals aged ≥ 18 years, and 414 of them were re-evaluated for test-retest reliability. The six sub-dimensions encompassed 60.3% of the total variance. Cronbach alpha coefficients were 0.82 for the entire scale and 0.92, 0.59, 0.67, 0.77, 0.72, and 0.76 for the sub-dimensions of definition, medical treatment, drug compliance, lifestyle, diet, and complications, respectively. The scale ensured internal consistency in reliability and construct validity, as well as stability over time. Significant relationships were found between knowledge score and age, gender, educational level, and history of hypertension of the participants. No correlation was found between knowledge score and working at an income-generating job. The present scale, developed to measure the knowledge level of hypertension among Turkish adults, was found to be valid and reliable.

  6. An ethnobotanical study of medicinal plants administered for the treatment of hypertension.

    Baharvand-Ahmadi, Babak; Bahmani, Mahmoud; Tajeddini, Pegah; Rafieian-Kopaei, Mahmoud; Naghdi, Nasrollah

    2016-01-01

    The incidence of cardiovascular diseases (CVDs) is very high in human societies and their prevention and treatment are the most important priority in many countries. Hypertension makes an important contribution to the development of CVDs. This study aimed to collect the ethno-medicinal knowledge of the traditional healers of Shiraz on medicinal plants used in the treatment of hypertension. Ethno-medicinal data were collected from September 2012 to July 2013 through direct interview. Twenty-five healers were interviewed using semi-structured questionnaires and their traditional ethno-medicinal knowledge was recorded. Questionnaires were included apothecary personal information, plant local name, plant parts used, method of preparation, season of harvest and traditional use. Data collected from surveys and interviews were transferred to Microsoft Excel 2007 and analyzed. Analysis of data showed that, 27 medicinal plants from 22 families are used for the treatment of hypertension. The families with most antihypertensive species were Apiaceae (8%), Rosaceae (8%) and Papaveraceae (8%). The most frequently used plant parts were leaves (36%) followed by fruits (30%), aerial part (17%) and branches (7%). The most frequently used preparation method was decoction (95%). Borago officinalis (51.85%), Berberis vulgaris (51.58%) had the highest frequency of mention. The ethno-medicinal survey of medicinal plants recommended by traditional healers for the treatment of hypertension provides new areas of research on the antihypertensive effect of medicinal plants. In the case of safety and effectiveness, they can be refined and processed to produce natural drugs.

  7. Genome-wide association study of blood pressure extremes identifies variant near UMOD associated with hypertension.

    Sandosh Padmanabhan

    2010-10-01

    Full Text Available Hypertension is a heritable and major contributor to the global burden of disease. The sum of rare and common genetic variants robustly identified so far explain only 1%-2% of the population variation in BP and hypertension. This suggests the existence of more undiscovered common variants. We conducted a genome-wide association study in 1,621 hypertensive cases and 1,699 controls and follow-up validation analyses in 19,845 cases and 16,541 controls using an extreme case-control design. We identified a locus on chromosome 16 in the 5' region of Uromodulin (UMOD; rs13333226, combined P value of 3.6 × 10⁻¹¹. The minor G allele is associated with a lower risk of hypertension (OR [95%CI]: 0.87 [0.84-0.91], reduced urinary uromodulin excretion, better renal function; and each copy of the G allele is associated with a 7.7% reduction in risk of CVD events after adjusting for age, sex, BMI, and smoking status (H.R. = 0.923, 95% CI 0.860-0.991; p = 0.027. In a subset of 13,446 individuals with estimated glomerular filtration rate (eGFR measurements, we show that rs13333226 is independently associated with hypertension (unadjusted for eGFR: 0.89 [0.83-0.96], p = 0.004; after eGFR adjustment: 0.89 [0.83-0.96], p = 0.003. In clinical functional studies, we also consistently show the minor G allele is associated with lower urinary uromodulin excretion. The exclusive expression of uromodulin in the thick portion of the ascending limb of Henle suggests a putative role of this variant in hypertension through an effect on sodium homeostasis. The newly discovered UMOD locus for hypertension has the potential to give new insights into the role of uromodulin in BP regulation and to identify novel drugable targets for reducing cardiovascular risk.

  8. Job Strain, Workplace Discrimination, and Hypertension among Older Workers: The Health and Retirement Study.

    Mezuk, Briana; Kershaw, Kiarri N; Hudson, Darrell; Lim, Kyuang Ah; Ratliff, Scott

    2011-03-01

    Job strain has been associated with hypertension among younger workers; however, whether this relationship persists among older workers, particularly older racial/ethnic minorities, is unresolved. This study evaluated whether job strain and workplace discrimination are associated with hypertension and poor blood pressure control among older workers and whether these relationships vary by gender and race/ethnicity. Data were drawn from the Health and Retirement Study, and analysis was restricted to employed participants with complete information on job strain and blood pressure (N = 3,794). In adjusted models, high job strain was associated with lower likelihood of hypertension (odds ratio (OR): 0.75, 95% confidence interval (CI): 0.63, 0.89) relative to low job strain. Stratified analyses indicated this association was only significant among white (OR: 0.71, 95% CI: 0.58, 0.86) and male (OR: 0.61, 95% CI: 0.47, 0.79) workers. High job strain was not significantly associated with hypertension among African American (OR: 1.14, 95% CI: 0.63, 2.07) or Hispanic (OR: 0.56, 95% CI: 0.29, 1.09) workers. Workplace discrimination was not associated with hypertension among any group. Neither job strain nor discrimination was associated with poor blood pressure control. These findings suggest that persistence in work characterized by high job strain in later life may signal resilience to the influence of work-related stressors on health. Future research efforts should examine the factors that contribute to gender and racial differences in these relationships.

  9. Diabetes and Hypertension in India: A Nationally Representative Study of 1.3 Million Adults.

    Geldsetzer, Pascal; Manne-Goehler, Jennifer; Theilmann, Michaela; Davies, Justine I; Awasthi, Ashish; Vollmer, Sebastian; Jaacks, Lindsay M; Bärnighausen, Till; Atun, Rifat

    2018-03-01

    Understanding how diabetes and hypertension prevalence varies within a country as large as India is essential for targeting of prevention, screening, and treatment services. However, to our knowledge there has been no prior nationally representative study of these conditions to guide the design of effective policies. To determine the prevalence of diabetes and hypertension in India, and its variation by state, rural vs urban location, and individual-level sociodemographic characteristics. This was a cross-sectional, nationally representative, population-based study carried out between 2012 and 2014. A total of 1 320 555 adults 18 years or older with plasma glucose (PG) and blood pressure (BP) measurements were included in the analysis. State, rural vs urban location, age, sex, household wealth quintile, education, and marital status. Diabetes (PG level ≥126 mg/dL if the participant had fasted or ≥200 mg/dL if the participant had not fasted) and hypertension (systolic BP≥140 mm Hg or diastolic BP≥90 mm Hg). Of the 1 320 555 adults, 701 408 (53.1%) were women. The crude prevalence of diabetes and hypertension was 7.5% (95% CI, 7.3%-7.7%) and 25.3% (95% CI, 25.0%-25.6%), respectively. Notably, hypertension was common even among younger age groups (eg, 18-25 years: 12.1%; 95% CI, 11.8%-12.5%). Being in the richest household wealth quintile compared with being in the poorest quintile was associated with only a modestly higher probability of diabetes (rural: 2.81 percentage points; 95% CI, 2.53-3.08 and urban: 3.47 percentage points; 95% CI, 3.03-3.91) and hypertension (rural: 4.15 percentage points; 95% CI, 3.68-4.61 and urban: 3.01 percentage points; 95% CI, 2.38-3.65). The differences in the probability of both conditions by educational category were generally small (≤2 percentage points). Among states, the crude prevalence of diabetes and hypertension varied from 3.2% (95% CI, 2.7%-3.7%) to 19.9% (95% CI, 17.6%-22.3%), and 18.0% (95% CI, 16

  10. Pulse wave imaging in normal, hypertensive and aneurysmal human aortas in vivo: a feasibility study

    Li, Ronny X; Luo, Jianwen; Shahmirzadi, Danial; Konofagou, Elisa E; Balaram, Sandhya K; Chaudhry, Farooq A

    2013-01-01

    Arterial stiffness is a well-established biomarker for cardiovascular risk, especially in the case of hypertension. The progressive stages of an abdominal aortic aneurysm (AAA) have also been associated with varying arterial stiffness. Pulse wave imaging (PWI) is a noninvasive, ultrasound imaging-based technique that uses the pulse wave-induced arterial wall motion to map the propagation of the pulse wave and measure the regional pulse wave velocity (PWV) as an index of arterial stiffness. In this study, the clinical feasibility of PWI was evaluated in normal, hypertensive, and aneurysmal human aortas. Radiofrequency-based speckle tracking was used to estimate the pulse wave-induced displacements in the abdominal aortic walls of normal (N = 15, mean age 32.5 ± 10.2 years), hypertensive (N = 13, mean age 60.8 ± 15.8 years), and aneurysmal (N = 5, mean age 71.6 ± 11.8 years) human subjects. Linear regression of the spatio-temporal variation of the displacement waveform in the anterior aortic wall over a single cardiac cycle yielded the slope as the PWV and the coefficient of determination r 2 as an approximate measure of the pulse wave propagation uniformity. The aortic PWV measurements in all normal, hypertensive, and AAA subjects were 6.03 ± 1.68, 6.69 ± 2.80, and 10.54 ± 6.52 m s −1 , respectively. There was no significant difference (p = 0.15) between the PWVs of the normal and hypertensive subjects while the PWVs of the AAA subjects were significantly higher (p 2 in the AAA subjects was significantly lower (p 2 ) obtained using PWI, in addition to the PWI images and spatio-temporal maps that provide qualitative visualization of the pulse wave, may potentially provide valuable information for the clinical characterization of aneurysms and other vascular pathologies that regionally alter the arterial wall mechanics. (paper)

  11. Retinal vessel diameter and estimated cerebrospinal fluid pressure in arterial hypertension: the Beijing Eye Study.

    Jonas, Jost B; Wang, Ningli; Wang, Shuang; Wang, Ya Xing; You, Qi Sheng; Yang, Diya; Wei, Wen Bin; Xu, Liang

    2014-09-01

    Hypertensive retinal microvascular abnormalities include an increased retinal vein-to-artery diameter ratio. Because central retinal vein pressure depends on cerebrospinal fluid pressure (CSFP), we examined whether the retinal vein-to-artery diameter ratio and other retinal hypertensive signs are associated with CSFP. Participants of the population-based Beijing Eye Study (n = 1,574 subjects) underwent measurement of the temporal inferior and superior retinal artery and vein diameter. CSFP was calculated as 0.44 × body mass index (kg/m(2)) + 0.16 × diastolic blood pressure (mm Hg) - 0.18 × age (years) - 1.91. Larger retinal vein diameters and higher vein-to-artery diameter ratios were significantly associated with higher estimated CSFP (P = 0.001) in multivariable analysis. In contrast, temporal inferior retinal arterial diameter was marginally associated (P = 0.03) with estimated CSFP, and temporal superior artery diameter was not significantly associated (P = 0.10) with estimated CSFP; other microvascular abnormalities, such as arteriovenous crossing signs, were also not significantly associated with estimated CSFP. In a reverse manner, higher estimated CSFP as a dependent variable in the multivariable analysis was associated with wider retinal veins and higher vein-to-artery diameter ratio. In the same model, estimated CSFP was not significantly correlated with retinal artery diameters or other retinal microvascular abnormalities. Correspondingly, arterial hypertension was associated with retinal microvascular abnormalities such as arteriovenous crossing signs (P = 0.003), thinner temporal retinal arteries (P arterial hypertension, an increased retinal vein-to-artery diameter ratio depends on elevated CSFP, which is correlated with blood pressure. © American Journal of Hypertension, Ltd 2014. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  12. Vitamin D and risk of pregnancy related hypertensive disorders: mendelian randomisation study.

    Magnus, Maria C; Miliku, Kozeta; Bauer, Anna; Engel, Stephanie M; Felix, Janine F; Jaddoe, Vincent W V; Lawlor, Debbie A; London, Stephanie J; Magnus, Per; McGinnis, Ralph; Nystad, Wenche; Page, Christian M; Rivadeneira, Fernando; Stene, Lars C; Tapia, German; Williams, Nicholas; Bonilla, Carolina; Fraser, Abigail

    2018-06-20

    To use mendelian randomisation to investigate whether 25-hydroxyvitamin D concentration has a causal effect on gestational hypertension or pre-eclampsia. One and two sample mendelian randomisation analyses. Two European pregnancy cohorts (Avon Longitudinal Study of Parents and Children, and Generation R Study), and two case-control studies (subgroup nested within the Norwegian Mother and Child Cohort Study, and the UK Genetics of Pre-eclampsia Study). 7389 women in a one sample mendelian randomisation analysis (751 with gestational hypertension and 135 with pre-eclampsia), and 3388 pre-eclampsia cases and 6059 controls in a two sample mendelian randomisation analysis. Single nucleotide polymorphisms in genes associated with vitamin D synthesis (rs10741657 and rs12785878) and metabolism (rs6013897 and rs2282679) were used as instrumental variables. Gestational hypertension and pre-eclampsia defined according to the International Society for the Study of Hypertension in Pregnancy. In the conventional multivariable analysis, the relative risk for pre-eclampsia was 1.03 (95% confidence interval 1.00 to 1.07) per 10% decrease in 25-hydroxyvitamin D level, and 2.04 (1.02 to 4.07) for 25-hydroxyvitamin D levels effect of 25-hydroxyvitamin D on the risk of gestational hypertension or pre-eclampsia: odds ratio 0.90 (95% confidence interval 0.78 to 1.03) and 1.19 (0.92 to 1.52) per 10% decrease, respectively. The two sample mendelian randomisation estimate gave an odds ratio for pre-eclampsia of 0.98 (0.89 to 1.07) per 10% decrease in 25-hydroxyvitamin D level, an odds ratio of 0.96 (0.80 to 1.15) per unit increase in the log(odds) of 25-hydroxyvitamin D level effect of vitamin D status on gestational hypertension or pre-eclampsia. Future mendelian randomisation studies with a larger number of women with pre-eclampsia or more genetic instruments that would increase the proportion of 25-hydroxyvitamin D levels explained by the instrument are needed. Published by the BMJ

  13. [A specific questionnaire to evaluate therapeutic inertia in hypertensive patients: a pilot study].

    Pretorean, T; Claisse, G; Delsart, P; Caudrelier, T; Devos, P; Mounier-Vehier, C

    2014-02-01

    Therapeutic inertia (TI) is a recent concept still unknown by many physicians. In chronic diseases such as hypertension, it is defined as the tendency of physicians not to increase or change antihypertensive medications when the target blood pressure is not reached. Acting on TI could improve blood pressure control in France. This was a single-center prospective pilot study conducted by hypertension specialist physicians at the University Cardio-Vascular Center in Lille (France). It was conducted between March and June 2011. Data was collected from 161 hypertensive patients (mean age: 61.64±11.18 years; 98 (60.9%) male; 75 secondary prevention patients). Each physician completed a questionnaire on therapeutic inertia. TI was defined as a consultation in which treatment change was indicated (systolic blood pressure [BP]≥140 and/or diastolic BP≥90mmHg in all patients), but did not occur, with absence of an adapted justification of this choice. We considered as an adapted justification: a white coat effect demonstrated by ambulatory blood pressure monitoring (ABPM) or home blood pressure monitoring; scheduled reassessment of the BP by ABPM; recent change in antihypertensive treatment (less than 4 weeks); hospitalization needed for complete evaluation of secondary causes of hypertension and a more detailed assessment of potential target organ damage in patients with grade 1 or 2 hypertension. Our study aimed to evaluate rates of TI, to identify factors associated with TI, and to test the TI questionnaire. Therapeutic inertia as defined in this study occurred in 11 consultations (8.3%) of the 133 hypertensive patients having uncontrolled BP above or equal to 140 and/or 90mmHg. Significant factors associated with TI were older age (Z=2.35, PP>0.05) and the number of consultations (Z=1.92, 0.1>P>0.05) exhibited a significant trend to be associated with TI. Although the rate of TI was low in our study conducted in a specialized center, a well-accepted definition of

  14. Portal Hypertension

    ... Overview of Gallbladder Cancer Additional Content Medical News Portal Hypertension By Steven K. Herrine, MD, Professor of Medicine, ... Liver Hepatic Encephalopathy Jaundice in Adults Liver Failure Portal Hypertension Portal hypertension is abnormally high blood pressure in ...

  15. [Secondary hypertension].

    Yoshida, Yuichi; Shibata, Hirotaka

    2015-11-01

    Hypertension is a common disease and a crucial predisposing factor of cardiovascular diseases. Approximately 10% of hypertensive patients are secondary hypertension, a pathogenetic factor of which can be identified. Secondary hypertension consists of endocrine, renal, and other diseases. Primary aldosteronism, Cushing's syndrome, pheochromocytoma, hyperthyroidism, and hypothyroidism result in endocrine hypertension. Renal parenchymal hypertension and renovascular hypertension result in renal hypertension. Other diseases such as obstructive sleep apnea syndrome are also very prevalent in secondary hypertension. It is very crucial to find and treat secondary hypertension at earlier stages since most secondary hypertension is curable or can be dramatically improved by specific treatment. One should keep in mind that screening of secondary hypertension should be done at least once in a daily clinical practice.

  16. Secondary Hypertension

    Secondary hypertension Overview Secondary hypertension (secondary high blood pressure) is high blood pressure that's caused by another medical condition. Secondary hypertension can be caused by conditions that affect your kidneys, ...

  17. Hypertension in pregnancy

    Andrea Ungar

    2007-03-01

    Full Text Available Hypertension is the most common medical problem encountered during pregnancy, complicating 2-3% of pregnancies. Hypertensive disorders during pregnancy are classified into 4 categories: chronic hypertension, pre-eclampsia/eclampsia, pre-eclampsia superimposed on chronic hypertension, and gestational hypertension. A relative paucity of investigative data, as well as the frequent difficulty in making an etiological diagnosis, may lead to problems in its management. This case report analyses current concepts regarding the hypertensive disorders of gestation, focusing on chronic hypertension. Chronic hypertension is defined as blood pressure exceeding 140/90 mmHg before pregnancy or before 20 weeks gestation. Hypertensive disorders in pregnancy may cause maternal and fetal morbidity and remain a leading source of maternal mortality. A prompt diagnosis is needed also because hypertension may be an indicator of pre-eclampsia, a condition which can evolve into serious complications. Maintaining blood pressure below 140/90 mmHg is recommended, although treatment should be determined on an individual basis. Many anti-hypertensive agents appear to be safe for use during pregnancy: methildopa has been the most studied of the anti-hypertensive drugs and has the best safety record. Labetalol, idralazine and nifedipine also have been found to be safe; ACE-inhibitors are absolutely contraindicated, because they are associated with intrauterine growth retardation.

  18. Non-replication study of a genome-wide association study for hypertension and blood pressure in African Americans

    Kidambi Srividya

    2012-04-01

    Full Text Available Abstract Background A recent genome wide association study in 1017 African Americans identified several single nucleotide polymorphisms that reached genome-wide significance for systolic blood pressure. We attempted to replicate these findings in an independent sample of 2474 unrelated African Americans in the Milwaukee metropolitan area; 53% were women and 47% were hypertensives. Methods We evaluated sixteen top associated SNPs from the above genome wide association study for hypertension as a binary trait or blood pressure as a continuous trait. In addition, we evaluated eight single nucleotide polymorphisms located in two genes (STK-39 and CDH-13 found to be associated with systolic and diastolic blood pressures by other genome wide association studies in European and Amish populations. TaqMan MGB-based chemistry with fluorescent probes was used for genotyping. We had an adequate sample size (80% power to detect an effect size of 1.2-2.0 for all the single nucleotide polymorphisms for hypertension as a binary trait, and 1% variance in blood pressure as a continuous trait. Quantitative trait analyses were performed both by excluding and also by including subjects on anti-hypertensive therapy (after adjustments were made for anti-hypertensive medications. Results For all 24 SNPs, no statistically significant differences were noted in the minor allele frequencies between cases and controls. One SNP (rs2146204 showed borderline association (p = 0.006 with hypertension status using recessive model and systolic blood pressure (p = 0.02, but was not significant after adjusting for multiple comparisons. In quantitative trait analyses, among normotensives only, rs12748299 was associated with SBP (p = 0.002. In addition, several nominally significant associations were noted with SBP and DBP among normotensives but none were statistically significant. Conclusions This study highlights the importance of replication to confirm the validity of genome wide

  19. Procollagen type III amino terminal peptide and myocardial fibrosis: A study in hypertensive patients with and without left ventricular hypertrophy.

    dos Santos Moreira, Carlos; Serejo, Fátima; Alcântara, Paula; Ramalhinho, Vítor; Braz Nogueira, J

    2015-05-01

    An exaggerated accumulation of type I and type III fibrillar collagens occurs throughout the free wall and interventricular septum of patients with primary hypertension and left ventricular hypertrophy (LVH). In the present study the serum concentration of procollagen type III amino terminal peptide (PIIIP) was measured to determine the value of this peptide as a potential marker of ventricular fibrosis in hypertensive patients, particularly those with LVH. The study population consisted of patients with never-treated mild to moderate essential hypertension and 30 normotensive control subjects. Clinical, echocardiographic, electrocardiographic and biochemical parameters were assessed in all patients. Heart rate, body mass index and levels of blood pressure were increased in hypertensives, particularly those with LVH, compared to normotensive controls. Posterior wall thickness, left ventricular (LV) mass and LV mass index, and serum PIIIP concentration were also increased in hypertensives, with significant differences between the two hypertensive groups. The ratio between maximal early and late transmitral flow velocity measured during diastole was lower in hypertensives, particularly those with LVH, than in normotensive controls. The increase in PIIIP indicates that type III collagen synthesis increases in hypertensives, particularly those with LVH, implying that alterations in the heart in hypertension are the result not solely of hypertrophied LV muscle, but also of increased collagen deposition within the ventricular wall and around the coronary vessels. Thus, measurement of serum PIIIP could be a practical and useful tool in the non-invasive assessment of myocardial remodeling in hypertension. Copyright © 2014 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.

  20. Gamma-glutamyltransferase, fatty liver index and hepatic insulin resistance are associated with incident hypertension in two longitudinal studies.

    Bonnet, Fabrice; Gastaldelli, Amalia; Pihan-Le Bars, Florence; Natali, Andrea; Roussel, Ronan; Petrie, John; Tichet, Jean; Marre, Michel; Fromenty, Bernard; Balkau, Beverley

    2017-03-01

    We hypothesized that liver markers and the fatty liver index (FLI) are predictive of incident hypertension and that hepatic insulin resistance plays a role. The association between liver markers and incident hypertension was analysed in two longitudinal studies of normotensive individuals, 2565 from the 9-year data from an epidemiological study on the insulin resistance cohort and the 321 from the 3-year 'Relationship between Insulin Sensitivity and Cardiovascular disease' cohort who had a measure of endogenous glucose production. The FLI is calculated from BMI, waist circumference, triglycerides and gamma-glutamyltransferase (GGT) and the hepatic insulin resistance index from endogenous glucose production and fasting insulin. The incidence of hypertension increased across the quartiles groups of both baseline GGT and alanine aminotransferase. After adjustment for sex, age, waist circumference, fasting glucose, smoking and alcohol intake, only GGT was significantly related with incident hypertension [standardized odds ratio: 1.21; 95% confidence interval (1.10-1.34); P = 0.0001]. The change in GGT levels over the follow-up was also related with an increased risk of hypertension, independently of changes in body weight. FLI analysed as a continuous value, or FLI at least 60 at baseline were predictive of incident hypertension in the multivariable model. In the RISC cohort, the hepatic insulin resistance index was positively related with the risk of 3-year incident hypertension [standardized odds ratio: 1.54 (1.07-2.22); P = 0.02]. Baseline GGT and FLI, as well as an increase in GGT over time, were associated with the risk of incident hypertension. Enhanced hepatic insulin resistance predicted the onset of hypertension and may be a link between liver markers and hypertension.

  1. Instruments of health literacy used in nursing studies with hypertensive elderly

    Ana Larissa Gomes Machado

    Full Text Available This study aimed to analyze nursing research regarding the instruments used to evaluate health literacy in elderly hypertensive patients. This is an integrative literature review done in the databases LILACS, PubMed, CINAHL, Scopus, and Cochrane, in June 2013. The articles, electronically available, were selected for full-text review by nurses, who assessed health literacy of elderly with hypertension. Eight studies were selected for analysis and four different instruments were used in the research. The instruments were developed according to a methodology and they were all designed to evaluate the abilities of elderly regarding reading, numeracy, pronunciation and recognition of some health-related words. The nursing research analyzed in this study revealed the gaps in care related to measures aimed to increase patient's involvement in decision-making. Also, the instruments used for measuring health literacy showed limitations, and there is no gold standard test.

  2. Pattern of utilization of benzodiazepines in patients with hypertension: A pilot study

    Divac Nevena

    2006-01-01

    Full Text Available Background/Aim. The analysis of drug prescribing in general practice in Serbia showed that the use of benzodiazepines is most frequently associated with hypertension. The aim of this study was to establish the correlation of the characteristics of patients with hypertension to antihypertensive drug therapy, and the intake of benzodiazepines. Methods. A special questionnaire was used for interviewing the patients (n = 171 chronically treated for hypertenson. Statistical tests used were χ2-test and Student's t-test. Results. No differences were noted in terms of age, gender, education, body weight, smoking habits and blood pressure (155±4.9/100±2.7 mmHg vs. 160±2.2/105±3.7 mmHg, between the group I (antihypertensive drugs+benzodiazepines: n = 79, and the group II (antihypertensives only: n = 92. The patients taking benzodiazepines received a lower number of different antihypertensive drugs (2.3±0.09 vs. 2.7±0.10; p < 0.01, but the total antihypertensive drug load was significantly greater than in the group II (2.6±0.10 vs. 1.9±0.15 defined daily doses (DDD/patient/day; p < 0.01. Benzodiazepines were taken for anxiety (62% and hypertension (21%, rarely for insomnia, mostly once a day, at bedtime. About half the patients took benzodiazepines regularly for months or years aware of the risk for addiction. Diazepam was used by 82% of the patients. The average daily exposure to benzodiazepines was 0.45±0.05 DDD/patient/day. The drug was bought without prescription in 25% of the patients, and without consulting a physician in 12% of them. Conclusion. The study confirmed a close association of hypertension with the use of benzodiazepines. The frequent use of benzodiazepines in the patients with hypertension might be caused by an inadequate response to antihypertensive drug therapy, besides anxiety and insomnia. The therapeutic efficacy of a long-term use of low doses of benzodiazepines in hypertension requires further investigation.

  3. Health-related quality of life in paediatric arterial hypertension: a cross-sectional study.

    Petek, Tadej; Hertiš, Tjaša; Marčun Varda, Nataša

    2018-05-01

    .34; p = .009). Pearson's r values ranged between 0.62 to 0.79 in patient and 0.56 to 0.80 in control sample (p < .001). Interestingly, hypertensive children reported lower social functioning scores than hypertensive adolescents (p < .001). This cross-sectional study gives insight into the detrimental impact of hypertension on children's and adolescents HRQoL, which may inform public health experts. Furthermore, it shows that clinicians should aim to improve patients' physical and psychosocial well-being throughout their development.

  4. Hypertension prevalence and living conditions related to air pollution: results of a national epidemiological study in Lebanon.

    Salameh, Pascale; Chahine, Mirna; Hallit, Souheil; Farah, Rita; Zeidan, Rouba Karen; Asmar, Roland; Hosseiny, Hassan

    2018-04-01

    Hypertension is a risk factor of several diseases, linked to high mortality and morbidity, particularly in developing countries. Some studies have linked indoor and outdoor pollution exposure items to hypertension, but results were inconsistent. Our objective was to assess the association of living conditions related to air pollution to hypertension in Lebanon, a Middle Eastern country. A national cross-sectional study was conducted all over Lebanon. Blood pressure and its related medications were assessed to be able to classify participants as hypertensive or not. Moreover, in addition to living conditions related to air pollution exposure, we assessed potential predictors of hypertension, including sociodemographic characteristics, self-reported health information and biological measurements. Furthermore, we assessed dose-effect relationship of air pollution items in relation with hypertension. Living conditions related to indoor and outdoor air pollution exposures were associated with hypertension, with or without taking biological values into account. Moreover, we found a dose-effect relationship of exposure with risk of disease (15% increase in risk of disease for every additional pollution exposure item), after adjustment for sociodemographics and biological characteristics (Ora = 1.15 [1.03-1.28]). Although additional studies would be necessary to confirm these findings, interventions should start to sensitize the population about the effect of air pollution on chronic diseases. The work on reducing pollution and improving air quality should be implemented to decrease the disease burden on the population and health system.

  5. Hypertension control in a large multi-ethnic cohort in Amsterdam, The Netherlands: the HELIUS study.

    Agyemang, Charles; Kieft, Suzanne; Snijder, Marieke B; Beune, Erik J; van den Born, Bert-Jan; Brewster, Lizzy M; Ujcic-Voortman, Joanne J; Bindraban, Navin; van Montfrans, Gert; Peters, Ron J; Stronks, Karien

    2015-03-15

    Hypertension is a major problem among European ethnic minority groups. We assessed the current situation of hypertension prevalence and its management among a multi-ethnic population in Amsterdam, The Netherlands. Data from the HELIUS study were used including 12,974 participants (1871 Ghanaian, 2184 African Surinamese, 2278 South-Asian Surinamese, 2277 Turkish, 2222 Moroccan and 2142 Dutch origin people), aged 18-70 years. Comparisons among groups were made using proportions and age-adjusted prevalence ratios (PRs). Hypertension prevalence ranged from 24% and 16% in Moroccan men and women to 52% and 62% in Ghanaian men and women. Except for Moroccan women, age-adjusted PR of hypertension was higher in all the ethnic minority groups than in Dutch. Among hypertensives, ethnic minority groups generally had higher levels of hypertension awareness and BP lowering treatment than Dutch. Moreover, prevalence rates for the prescription of more than one BP lowering drug were generally higher in African and South-Asian origin groups compared with Dutch origin people. By contrast, BP control levels were lower in all the ethnic groups than in Dutch, with control rates being significantly lower in Ghanaian men (26%, PR=0.49; 95% CI, 0.37-0.66) and women (45%, PR=0.64; 0.52-0.77), African-Surinamese men (30%, PR=0.61; 0.46-0.81) and women (45%, PR=0.72; 0.51-0.77), and South-Asian Surinamese men (43%, PR=0.77; 0.61-0.97) and women (47%, PR=0.76; 0.63-0.92) compared with Dutch men (53%) and women (61%). Our findings indicate poor BP control in ethnic minority groups despite the high treatment levels. More work is needed to unravel the potential factors contributing to the poor control in order to improve BP control in ethnic minority groups, particularly among African and South-Asian origin groups. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  6. [Experimental study of acute brain swelling under acute intracranial hypertension (author's transl)].

    Shigemori, M; Watanabe, M; Kuramoto, S

    1976-12-01

    There are many problems about the cause, pathophysiology and treatment of acute brain swelling under intracranial hypertension frequently encountered in the neurosurgical clinics. Generally, rapid increase of the cerebral vasoparesis caused by unknown etiology is thought to be the main cause of acute brain swelling under intracranial hypertension. Moreover, disturbance of the cerebral venous circulatory system is discussed recently by many authors. But, research from the point of systemic respiration and hemodynamics is necessary for resolving these problems. This experiment was designed to study the effects of respiration and hemodynamics on the cerebral vasoparesis. Using 22 adult dogs, acute intracranial hypertension was produced by epidural balloon inflation sustained at the level of 300 - 400 mmH2O. Simultaneously with measurement of intracranial pressure at the epidural space, superior sagittal sinus pressure, respirogram, systemic blood pressure (femoral artery), central venous pressure, common carotid blood flow, EKG and bipolar lead EEG were monitored continuously. The experimental group was divided by the respiratory loading into 5 groups as follows: control (6 cases), 10% CO2 hypercapnia (4 cases), 10% O2 hypoxia (4 cases), stenosis of airway (5 cases), 100% O2-controled respiration (3 cases). 1) Cerebral vasoparesis under acute intracranial hypertension took place earlier and showed more rapid progression in groups of stenosis of airway, hypercapnia and hypoxia than control group of spontaneous respiration in room air. No occurrence of cerebral vasoparesis was found out in a group of 100% O2 controlled respiration. It is proved that increased airway resistance or asphyxia, hypercapnia and hypoxia have strictly reference to the occurrence and progression of cerebral vasoparesis and for the prevention of cerebral vasoparesis, correct 100% O2 cont rolled respiration is effective. 2) From the hemodynamic change, the progression of rapid increase of cerebral

  7. Autoradiographic study of the regional distribution of gastric blood flow in portal hypertensive rats

    Geraghty, J.G.; Angerson, W.J.; Carter, D.C.

    1989-01-01

    This study measures regional gastric blood flow in portal hypertensive rats at three separate periods after portal vein ligation using quantitative autoradiography with 14C-labeled iodoantipyrine. The level of corpus mucosal blood flow was significantly reduced in 3-day portal vein-ligated animals compared with sham-operated control animals (30.4 +/- 2.3 vs. 47.1 +/- 5.6 ml/100 g.min). There was no significant difference in corpus mucosal blood flow between portal vein-ligated and sham-operated animals at 7- and 28-day periods, although the level of perfusion was higher in the 28-day portal vein-ligated group. There was no significant difference in antral mucosal or muscle blood flow between portal hypertensive and control animals at any of the study periods. We conclude that the acute period after portal vein ligation is associated with a reduced corpus mucosal microcirculation but that this effect is not sustained in portal hypertensive animals studied at later intervals after portal vein ligation

  8. Relationship between systemic hypertension, perfusion pressure and glaucoma: A comparative study in an adult Indian population

    Amit K Deb

    2014-01-01

    Full Text Available Aims: To study the relationship between blood pressure (BP, intraocular pressure (IOP, mean ocular perfusion pressure (MOPP and primary open angle glaucoma (POAG in patients with hypertension and compare it to a control group of normotensives. Design: Cross-sectional observational study. Materials and Methods: A total of 108 subjects with primary hypertension and 100 age-matched controls without hypertension were enrolled for the study. IOP measurement using Noncontact Tonometer and dilated fundus evaluation using + 90 D lens were done for all cases. Single recording of BP was taken. Gonioscopy, Humphrey′s central visual fields, optical coherence tomography and pachymetry were done for all subjects with IOP > 21 mm Hg or C: D ratio ≥ 0.5 or asymmetry of > 0.2. Statistical Analysis: Univariate and multivariate multinomial regression models were used to determine the association between covariates and risk of glaucoma or glaucoma suspect. Results: There was no difference in the glaucoma status between subjects with and without hypertension. Subjects on antihypertensive medications were 1΍ times more likely to have suspicious glaucoma (odds ratio [OR] =1.56] and nearly twice as likely to have POAG (OR = 1.85. In addition, we found a 31% and 12% reduction in risk of having POAG (95% confidence interval [CI] =13-45%, P = 0.001 and glaucoma suspect (95% CI = 2-21%, P = 0.03 respectively with every 1 mm Hg increment in MOPP. Conclusion: Subjects on antihypertensive medications are more likely to have either glaucoma or glaucoma suspect, and higher ocular perfusion pressure offers relative protection from glaucomatous damage.

  9. Effects of atrial natriuretic peptide on glomerular filtration rate in essential hypertension: A radionuclide study

    Cuocolo, A.; Volpe, M.; Mele, A.F.; Celentano, L.; Neumann, R.D.; Trimarco, B.; Salvatore, M. (Naples Univ. (Italy). Ist. di Scienze Radiologiche Istituto Nazionale dei Tumori, Naples (Italy))

    1991-01-01

    A number of studies show that atrial natriuretic peptide (ANP) raises renal sodium excretion with a concomitant increase in glomerular filtration rate (GFR) in both experimental animals and normal humans. Studies using indirect evaluation of GFR have provided less consistent results in hypertensive patients. We studied the effects of intravenously administered (iv) {alpha}-human ANP on GFR in patients with hypertension by a radionuclide technique using technetium 99m diethylenetriaminepenta-acetic acid. In six patients (ANP group), GFR was determined under control conditions, during iv ANP (initial bolus of 0.5 {mu}g/kg followed by a 21-min maintenance infusion at 0.05 {mu}g.kg{sup -1}.min{sup -1}) and during a recovery phase. In six other patients (control group), GFR was determined under control conditions, during saline iv infusion and during recovery. The two groups did not differ with respect to age, sex, basal blood pressure, heart rate or GFR. In the ANP group, the infusion of the peptide induced a significant decrease of mean blood pressure (from 133+-5 to 120+-5 mmHg, P<0.01), no change in heart rate and a significant increase in GFR (from 104+-4 to 125+-5 ml/min, P<0.01). During recovery, blood pressure, heart rate and GFR were not different from the values recorded under control conditions. No changes in blood pressure, heart rate or GFR (from 106+-5 to 108+-5 ml/min, n.s.) were detected during saline infusion in the control group. Our results demonstrated that in patients with essential hypertension, ANP induces an augmentation in GFR in spite of a decrease in blood pressure; this suggests a unique role for atrial peptide-related drugs in the treatment of human hypertension. (orig.).

  10. Technetium-99m DTPA renal flow studies in Goldblatt hypertension

    Nally, J.V.; Clarke, H.S.; Windham, J.P.; Grecos, G.P.; Gross, M.L.; Potvin, W.J.

    1985-01-01

    Computer-assisted dynamic renal studies were performed on a group of 14 mongrel dogs before and after the induction of unilateral renal artery stenosis. Ninety-second technetium-99m diethylenetriaminepentaacetic acid ([/sup 99m/Tc]DTPA), 15-min [/sup 99m/Tc]DTPA, and 30-min iodine-131 orthoiodohippurate ([ 131 I]hippuran) time-activity curves were analyzed and correlated with reduction of renal blood flow as measured by electromagnetic flow probe and PAH clearance techniques. For blood flow reductions greater than 33%, the [/sup 99m/Tc]DTPA studies were judged diagnostic of unilateral renal artery stenosis in all cases, whereas the [ 131 I]hippuran time-activity curves were indicative of stenosis in only six of ten studies. Thus, in this model we find the computer-assisted 90-sec [/sup 99m/Tc]DTPA renal flow study to be superior to conventional [ 131 I]hippuran renography in the diagnosis of moderate-to-serve unilateral renal artery stenosis

  11. Perivesical varices and portal hypertension: imaging study; Varices perivesiculares e hipertension postal. Estudio por imagen

    Mallorquin Jimenez, F; Medina Benitez, A; Lopez Machado, E; Pardo Moreno, M D; Garrido Moreno, C; Pastor Rull, J [Servicio de Radiodiagnostico, Hospital General de Especialidades Virgen de la Nieve, Granada (Spain)

    1995-07-01

    Nine patients with portal hypertension syndrome and Perivesical varices are studied retrospectively by means of imaging techniques including ultrasound, duplex Doppler, color Doppler, CT and angiography. All the patients presented portal thrombosis and thickening of the bladder wall. These collaterals either represent a shunting of hepato pedal flow or correspond to blood stasis associated with said syndrome. Ultrasound, whether involving duplex Doppler or color Doppler techniques, is highly useful to detect the presence of Perivesical varices which appear as tubular or rounded hypo echogenic areas in the bladder wall. Given the association of this entity with bladder wall thickening, it should be taken into account in any clinical situation involving said change, especially in patients with portal hypertension; moreover knowledge of its presence is of great importance when the possibility of creating shunts by means of interventional or surgical vascular procedures or other types of abdominal procedures are being considered because of the risk of bleeding. (Author)

  12. Severe hypertensive syndrome – descriptive study with adolescents attended at a maternity school

    Andreia Gregório Lima

    2012-06-01

    Full Text Available This is an exploratory and descriptive study with the objective of analyzing the clinical and obstetric data related to the severe hypertensive disorders in adolescents assisted at a maternity school of Recife. The population was consisted of 186 pregnant adolescents with severe preeclampsia and/or eclampsia between 2003 and 2008. The age ranged between 15 and 19 years; they were black, single and had low education. Most of them were primiparas but the pregnancy recurrence was configured at 16% of cases. They did six or more prenatal consultations. The pregnancy progressed to term and the most frequent type of delivery was cesarean section. The comorbidities identified were changes in amniotic fluid volume, hemorrhages and infections. There were also identified cases of intrauterine growth retardation, prematurity, jaundice, hypoxia and low birth weight. It was concluded that teenage pregnancy associated with severe hypertensive syndrome is related to severe maternal, fetal and neonatal complications.

  13. First Trimester Urine and Serum Metabolomics for Prediction of Preeclampsia and Gestational Hypertension: A Prospective Screening Study

    Marie Austdal

    2015-09-01

    Full Text Available Hypertensive disorders of pregnancy, including preeclampsia, are major contributors to maternal morbidity. The goal of this study was to evaluate the potential of metabolomics to predict preeclampsia and gestational hypertension from urine and serum samples in early pregnancy, and elucidate the metabolic changes related to the diseases. Metabolic profiles were obtained by nuclear magnetic resonance spectroscopy of serum and urine samples from 599 women at medium to high risk of preeclampsia (nulliparous or previous preeclampsia/gestational hypertension. Preeclampsia developed in 26 (4.3% and gestational hypertension in 21 (3.5% women. Multivariate analyses of the metabolic profiles were performed to establish prediction models for the hypertensive disorders individually and combined. Urinary metabolomic profiles predicted preeclampsia and gestational hypertension at 51.3% and 40% sensitivity, respectively, at 10% false positive rate, with hippurate as the most important metabolite for the prediction. Serum metabolomic profiles predicted preeclampsia and gestational hypertension at 15% and 33% sensitivity, respectively, with increased lipid levels and an atherogenic lipid profile as most important for the prediction. Combining maternal characteristics with the urinary hippurate/creatinine level improved the prediction rates of preeclampsia in a logistic regression model. The study indicates a potential future role of clinical importance for metabolomic analysis of urine in prediction of preeclampsia.

  14. First Trimester Urine and Serum Metabolomics for Prediction of Preeclampsia and Gestational Hypertension: A Prospective Screening Study.

    Austdal, Marie; Tangerås, Line H; Skråstad, Ragnhild B; Salvesen, Kjell; Austgulen, Rigmor; Iversen, Ann-Charlotte; Bathen, Tone F

    2015-09-08

    Hypertensive disorders of pregnancy, including preeclampsia, are major contributors to maternal morbidity. The goal of this study was to evaluate the potential of metabolomics to predict preeclampsia and gestational hypertension from urine and serum samples in early pregnancy, and elucidate the metabolic changes related to the diseases. Metabolic profiles were obtained by nuclear magnetic resonance spectroscopy of serum and urine samples from 599 women at medium to high risk of preeclampsia (nulliparous or previous preeclampsia/gestational hypertension). Preeclampsia developed in 26 (4.3%) and gestational hypertension in 21 (3.5%) women. Multivariate analyses of the metabolic profiles were performed to establish prediction models for the hypertensive disorders individually and combined. Urinary metabolomic profiles predicted preeclampsia and gestational hypertension at 51.3% and 40% sensitivity, respectively, at 10% false positive rate, with hippurate as the most important metabolite for the prediction. Serum metabolomic profiles predicted preeclampsia and gestational hypertension at 15% and 33% sensitivity, respectively, with increased lipid levels and an atherogenic lipid profile as most important for the prediction. Combining maternal characteristics with the urinary hippurate/creatinine level improved the prediction rates of preeclampsia in a logistic regression model. The study indicates a potential future role of clinical importance for metabolomic analysis of urine in prediction of preeclampsia.

  15. Football as a treatment for hypertension in untrained 30-55-year-old men: a prospective randomized study

    Andersen, Lars Juel; Randers, Morten Bredsgaard; Westh, K.

    2010-01-01

    The present study investigated whether football has favorable effects in the treatment of mild-to-moderate arterial hypertension in untrained middle-aged men. Twenty-five untrained males aged 31-54 year with mild-to-moderate hypertension were randomized to a football training group (FTG, two 1-h.......p.m.), whereas no change was observed for DAG. After 3 months, FTG had higher (Pattractive non-pharmacological supplement...... to the treatment of mild-to-moderate arterial hypertension in untrained middle-aged men....

  16. Lack of control of hypertension in primary cardiovascular disease prevention in Europe: Results from the EURIKA study.

    Borghi, Claudio; Tubach, Florence; De Backer, Guy; Dallongeville, Jean; Guallar, Eliseo; Medina, Jesús; Perk, Joep; Roy, Carine; Banegas, José R; Rodriguez-Artalejo, Fernando; Halcox, Julian P

    2016-09-01

    The prevalence of and factors associated with uncontrolled hypertension and apparent resistant hypertension were assessed in the European Study on Cardiovascular Risk Prevention and Management in Usual Daily Practice (EURIKA; NCT00882336). EURIKA was a cross-sectional observational study including patients being treated for the primary prevention of cardiovascular disease in 12 European countries. Patients were assessed if they were being treated for hypertension (N=5220). Blood pressure control was defined according to European guidelines, with sensitivity analysis taking account of patients' age and diabetes status. Associated factors were assessed using multivariate analysis. In the primary analysis, a total of 2691 patients (51.6%) had uncontrolled hypertension. Factors significantly associated with an increased risk of having uncontrolled hypertension included female sex (odds ratio [OR]: 2.29; 95% confidence interval [CI]: 1.93-2.73), body mass index (BMI; OR per kg/m(2): 1.03; 95% CI: 1.01-1.04), and geographic location. A total of 749 patients (14.3%) had apparent resistant hypertension. Factors significantly associated with an increased risk of having apparent resistant hypertension included BMI (OR per kg/m(2): 1.06; 95% CI: 1.04-1.08), diabetes (OR: 1.28; 95% CI: 1.06-1.53), use of statins (OR: 1.36; 95% CI: 1.15-1.62), serum uric acid levels (OR: 1.16; 95% CI: 1.09-1.23), and geographic location. Similar results were seen in sensitivity analyses. Over 50% of patients treated for hypertension continued to have uncontrolled blood pressure and 14.3% had apparent resistant hypertension. Positive associations were seen with other cardiovascular risk factors. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  17. Dose-Response Association Between Physical Activity and Incident Hypertension: A Systematic Review and Meta-Analysis of Cohort Studies.

    Liu, Xuejiao; Zhang, Dongdong; Liu, Yu; Sun, Xizhuo; Han, Chengyi; Wang, Bingyuan; Ren, Yongcheng; Zhou, Junmei; Zhao, Yang; Shi, Yuanyuan; Hu, Dongsheng; Zhang, Ming

    2017-05-01

    Despite the inverse association between physical activity (PA) and incident hypertension, a comprehensive assessment of the quantitative dose-response association between PA and hypertension has not been reported. We performed a meta-analysis, including dose-response analysis, to quantitatively evaluate this association. We searched PubMed and Embase databases for articles published up to November 1, 2016. Random effects generalized least squares regression models were used to assess the quantitative association between PA and hypertension risk across studies. Restricted cubic splines were used to model the dose-response association. We identified 22 articles (29 studies) investigating the risk of hypertension with leisure-time PA or total PA, including 330 222 individuals and 67 698 incident cases of hypertension. The risk of hypertension was reduced by 6% (relative risk, 0.94; 95% confidence interval, 0.92-0.96) with each 10 metabolic equivalent of task h/wk increment of leisure-time PA. We found no evidence of a nonlinear dose-response association of PA and hypertension ( P nonlinearity =0.094 for leisure-time PA and 0.771 for total PA). With the linear cubic spline model, when compared with inactive individuals, for those who met the guidelines recommended minimum level of moderate PA (10 metabolic equivalent of task h/wk), the risk of hypertension was reduced by 6% (relative risk, 0.94; 95% confidence interval, 0.92-0.97). This meta-analysis suggests that additional benefits for hypertension prevention occur as the amount of PA increases. © 2017 American Heart Association, Inc.

  18. Increased planned delivery contributes to declining rates of pregnancy hypertension in Australia: a population-based record linkage study.

    Roberts, Christine L; Algert, Charles S; Morris, Jonathan M; Ford, Jane B

    2015-10-05

    Since the 1990s, pregnancy hypertension rates have declined in some countries, but not all. Increasing rates of early planned delivery (before the due date) have been hypothesised as the reason for the decline. The aim of this study was to explore whether early planned delivery can partly explain the declining pregnancy hypertension rates in Australia. Population-based record linkage study utilising linked birth and hospital records. A cohort of 1,076,122 deliveries in New South Wales, Australia, 2001-2012. Pregnancy hypertension (including gestational hypertension, pre-eclampsia and eclampsia) was the main outcome; pre-eclampsia was a secondary outcome. From 2001 to 2012, pregnancy hypertension rates declined by 22%, from 9.9% to 7.7%, and pre-eclampsia by 27%, from 3.3% to 2.4% (trend prate was predicted to increase to 10.5%. Examination of annual gestational age distributions showed that pregnancy hypertension rates actually declined from 38 weeks gestation and were steepest from 41 weeks; at least 36% of the decrease could be attributed to planned deliveries. The risk factors for pregnancy hypertension were also risk factors for planned delivery. It appears that an unanticipated consequence of increasing early planned deliveries is a decline in the incidence of pregnancy hypertension. Women with risk factors for hypertension were relatively more likely to be selected for early delivery. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  19. Influence of White-Coat Hypertension on Left Ventricular Deformation 2- and 3-Dimensional Speckle Tracking Study.

    Tadic, Marijana; Cuspidi, Cesare; Ivanovic, Branislava; Ilic, Irena; Celic, Vera; Kocijancic, Vesna

    2016-03-01

    We sought to compare left ventricular deformation in subjects with white-coat hypertension to normotensive and sustained hypertensive patients. This cross-sectional study included 139 untreated subjects who underwent 24-hour ambulatory blood pressure monitoring and completed 2- and 3-dimensional examination. Two-dimensional left ventricular multilayer strain analysis was also performed. White-coat hypertension was diagnosed if clinical blood pressure was elevated and 24-hour blood pressure was normal. Our results showed that left ventricular longitudinal and circumferential strains gradually decreased from normotensive controls across subjects with white-coat hypertension to sustained hypertensive group. Two- and 3-dimensional left ventricular radial strain, as well as 3-dimensional area strain, was not different between groups. Two-dimensional left ventricular longitudinal and circumferential strains of subendocardial and mid-myocardial layers gradually decreased from normotensive control to sustained hypertensive group. Longitudinal and circumferential strains of subepicardial layer did not differ between the observed groups. We concluded that white-coat hypertension significantly affects left ventricular deformation assessed by 2-dimensional traditional strain, multilayer strain, and 3-dimensional strain. © 2016 American Heart Association, Inc.

  20. A qualitative study on hypertensive care behavior in primary health care settings in Malaysia

    Shima R

    2014-11-01

    Full Text Available Razatul Shima,1,3 Mohd Hairi Farizah,1,2 Hazreen Abdul Majid1,2 1Department of Social and Preventive Medicine; 2Centre for Population Health, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; 3Ministry of Health Malaysia, Putrajaya, Malaysia Purpose: The aim of this study was to explore patients’ experiences with their illnesses and the reasons which influenced them in not following hypertensive care recommendations (antihypertensive medication intake, physical activity, and diet changes in primary health clinic settings. Patients and methods: A qualitative methodology was applied. The data were gathered from in-depth interviews with 25 hypertensive patients attending follow-up in nine government primary health clinics in two districts (Hulu Langat and Klang in the state of Selangor, Malaysia. The transcribed data were analyzed using thematic analysis.Results: There was evidence of lack of patient self-empowerment and community support in Malaysian society. Most of the participants did not take their antihypertensive medication or change their physical activity and diet after diagnosis. There was an agreement between the patients and the health care professionals before starting the treatment recommendation, but there lacked further counseling and monitoring. Most of the reasons given for not taking antihypertensive medication, not doing physical activity and not following diet recommendations were due to side effects or fear of the side effects of antihypertensive medication, patients’ attitudes, lack of information from health care professionals and insufficient social support from their surrounding environment. We also observed the differences on these reasons for nonadherence among the three ethnic groups.Conclusion: Health care professionals should move toward supporting adherence in the management of hypertensive patients by maintaining a dialogue. Patients need to be given time to enable them to overcome their

  1. Coffee, tea, caffeine, and risk of hypertension: The Singapore Chinese Health Study.

    Chei, Choy-Lye; Loh, Julian Kenrick; Soh, Avril; Yuan, Jian-Min; Koh, Woon-Puay

    2018-06-01

    The relationship between coffee and tea, and risk of hypertension remains controversial in Western populations. We investigated these associations in an Asian population. The Singapore Chinese Health Study is a population-based prospective cohort that recruited 63,257 Chinese aged 45-74 years and residing in Singapore from 1993 to 1998. Information on consumption of coffee, tea, and other lifestyle factors was collected at baseline, and self-reported physician-diagnosed hypertension was assessed during two follow-up interviews (1999-2004, 2006-2010). We identified 13,658 cases of incident hypertension after average 9.5 years. Compared to those who drank one cup of coffee/day, the hazard ratios (HR) and 95% confidence intervals (CI) were 0.87 (0.83-0.91) for hypertension risk; compared to the lowest intake (<50 mg/day), those in the highest intake (≥300 mg/day) had a 16% increase in risk; HR 1.16, 95% CI 1.04-1.31 (p trend = 0.02). Drinking coffee <1 cup/week or ≥3 cups/day had lower risk than drinking one cup/day. Caffeine may account for increased risk in daily tea drinkers and in those who drank one cup of coffee/day. The inverse U-shaped association with coffee suggests that at higher doses, other ingredients in coffee may offset the effect of caffeine and confer benefit on blood pressure.

  2. Functional Vascular Study in Hypertensive Subjects with Type 2 Diabetes Using Losartan or Amlodipine

    Cesar Romaro Pozzobon

    2014-07-01

    Full Text Available Background: Antihypertensive drugs are used to control blood pressure (BP and reduce macro- and microvascular complications in hypertensive patients with diabetes. Objectives: The present study aimed to compare the functional vascular changes in hypertensive patients with type 2 diabetes mellitus after 6 weeks of treatment with amlodipine or losartan. Methods: Patients with a previous diagnosis of hypertension and type 2 diabetes mellitus were randomly divided into 2 groups and evaluated after 6 weeks of treatment with amlodipine (5 mg/day or losartan (100 mg/day. Patient evaluation included BP measurement, ambulatory BP monitoring, and assessment of vascular parameters using applanation tonometry, pulse wave velocity (PWV, and flow-mediated dilation (FMD of the brachial artery. Results: A total of 42 patients were evaluated (21 in each group, with a predominance of women (71% in both groups. The mean age of the patients in both groups was similar (amlodipine group: 54.9 ± 4.5 years; losartan group: 54.0 ± 6.9 years, with no significant difference in the mean BP [amlodipine group: 145 ± 14 mmHg (systolic and 84 ± 8 mmHg (diastolic; losartan group: 153 ± 19 mmHg (systolic and 90 ± 9 mmHg (diastolic]. The augmentation index (30% ± 9% and 36% ± 8%, p = 0.025 and augmentation pressure (16 ± 6 mmHg and 20 ± 8 mmHg, p = 0.045 were lower in the amlodipine group when compared with the losartan group. PWV and FMD were similar in both groups. Conclusions: Hypertensive patients with type 2 diabetes mellitus treated with amlodipine exhibited an improved pattern of pulse wave reflection in comparison with those treated with losartan. However, the use of losartan may be associated with independent vascular reactivity to the pressor effect.

  3. Home blood-pressure monitoring in a hypertensive pregnant population: cost minimisation study.

    Xydopoulos, G; Perry, H; Sheehan, E; Thilaganathan, B; Fordham, R; Khalil, A

    2018-03-08

    Traditional monitoring of blood pressure in hypertensive pregnant women requires frequent visits to the maternity outpatient services. Home blood-pressure monitoring (HBPM) could offer a cost-saving alternative that is acceptable to patients. The main objective of this study was to undertake a health economic analysis of HBPM compared with traditional monitoring in hypertensive pregnant women. This was a case-control study. Cases were pregnant women with hypertension who had HBPM with or without the adjunct of a smartphone app, via a specially designed pathway. The control group were managed as per existing hospital guidelines. Specific outcome measures were the number of outpatient visits, inpatient bed stays and investigations performed. Maternal, fetal and neonatal adverse outcomes were also recorded. Health economic analysis was performed using two methods: direct cost comparison of the study dataset and process scenario modelling. There were 108 women in the HBPM group, of whom 29 recorded their results on the smartphone app (App-HBPM) and 79 in their notes (Non-app HBPM). The control group comprised of 58 patients. There were significantly more women with chronic hypertension in the HBPM group (49.1% vs 25.9%, P = 0.004). The HBPM group had significantly longer duration of monitoring (9 weeks vs 5 weeks P = 0.004) and started monitoring from an earlier gestation (30 weeks vs 33.6 weeks, P = 0.001). Despite these differences, the mean saving per week for HBPM compared with the control group was £200.69. For the App-HBPM cohort, the saving per week compared with the control group was £286.53. The process modelling method predicted savings of between £98.32 and £245.80 per week using HBPM compared to the traditional monitoring. HBPM in hypertensive pregnancies appears to be cost-saving compared with traditional monitoring, without compromising maternal, fetal or neonatal safety. Larger studies are required to confirm these findings. This article is

  4. Prevalence, awareness, treatment, and control rate of hypertension in HIV-infected patients: the HIV-HY study.

    De Socio, Giuseppe Vittorio; Ricci, Elena; Maggi, Paolo; Parruti, Giustino; Pucci, Giacomo; Di Biagio, Antonio; Calza, Leonardo; Orofino, Giancarlo; Carenzi, Laura; Cecchini, Enisia; Madeddu, Giordano; Quirino, Tiziana; Schillaci, Giuseppe

    2014-02-01

    We aimed to assess the prevalence of hypertension in an unselected human immunodeficiency virus (HIV)-infected population and to identify factors associated with hypertension prevalence, treatment, and control. We used a multicenter, cross-sectional, nationwide study that sampled 1,182 unselected, consecutive, HIV-infected patients. Office blood pressure was accurately measured with standard procedures. Patients were 71% men and 92% white, with a median age of 47 years (range = 18-78); 6% were antiretroviral treatment naive. The overall prevalence of hypertension was 29.3%; high-normal pressure accounted for an additional 12.3%. Among hypertensive subjects, 64.9% were aware of their hypertensive condition, 52.9% were treated, and 33.0% were controlled (blood pressure < 140/90 mm Hg). Blood pressure-lowering medications were used in monotherapy in 54.3% of the subjects. Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers were the most frequently used drugs (76.1%: monotherapy = 39.1%, combination treatment = 37.0%). In multivariable regression models, hypertension was independently predicted by traditional risk factors, including age ≥50 years, male sex, family history of cardiovascular disease, body mass index ≥25 kg/m2, previous cardiovascular events, diabetes, central obesity, and metabolic syndrome, as well as by duration of HIV infection, duration of antiretroviral therapy, and nadir CD4+ T-cell count <200/μl. The choice of protease inhibitors vs. nonnucleoside reverse transcriptase inhibitors as a third antiretroviral drug was irrelevant. Hypertension affects nearly 30% of HIV adult outpatients in Italy. More than one-third of the hypertensive subjects are unaware of their condition, and more than two-thirds are uncontrolled. A higher level of attention to the diagnosis and treatment of hypertension is mandatory in this setting.

  5. Controlling Hypertension

    Hypertension, or high blood pressure, affects one third of U.S. adults and is a leading cause of heart disease and stroke. A recent study found an increase in self-reported high blood pressure among U.S. adults, and an increase in the use of medications to control high blood pressure. In this podcast, Dr. Fleetwood Loustalot discusses the importance of controlling high blood pressure.

  6. A randomised controlled trial for the evaluation of risk for type 2 diabetes in hypertensive patients receiving thiazide diuretics: Diuretics In the Management of Essential hypertension (DIME) study

    Ueda, Shinichiro; Morimoto, Takeshi; Ando, Shin-ichi; Takishita, Shu-ichi; Kawano, Yuhei; Shimamoto, Kazuaki; Ogihara, Toshio; Saruta, Takao

    2014-01-01

    Objectives Thiazide diuretics are one of the first choice antihypertensives but not optimally utilised because of concerns regarding their adverse effects on glucose metabolism. The Diuretics In the Management of Essential hypertension (DIME) study was designed, for the first time, to assess the risk for type 2 diabetes mellitus in patients with essential hypertension during antihypertensive treatment with low-dose thiazide diuretics compared to those not treated with diuretics. Design Multicentre, unblinded, pragmatic, randomised, controlled trial with blinded assessment of end points and intention-to-treat analysis that was started in 2004 and finished in 2012. Setting Hypertension clinics at 106 sites in Japan, including general practitioners’ offices and teaching hospitals. Participants Non-diabetic patients with essential hypertension. Interventions Antihypertensive treatment with low-dose thiazide diuretics at 12.5 mg/day of hydrochlorothiazide or equivalent (Diuretics group) or that without thiazide diuretics (No-diuretics group). Main outcome The primary outcome was new onset of type 2 diabetes diagnosed according to WHO criteria and the criteria of Japanese Society of Diabetes. Results 1130 patients were allocated to Diuretics (n=544) or No-diuretics group (n=586). Complete end point information was collected for 1049 participants after a median follow-up of 4.4 years. Diabetes developed in 25 (4.6%) participants in the Diuretics group, as compared with 29 (4.9%) in the No-diuretics group (HR 0.93; 95% CI 0.55 to 1.58; p=0.800). Conclusions Antihypertensive treatment with thiazide diuretics at low doses may not be associated with an increased risk for new onset of type 2 diabetes. This result might suggest safety of use of low doses of thiazide diuretics. Trial registration number ClinicalTrials.gov NCT00131846. PMID:25031188

  7. "I have to live like I'm old." Young adults' perspectives on managing hypertension: a multi-center qualitative study.

    Johnson, Heather M; Warner, Ryan C; LaMantia, Jamie N; Bowers, Barbara J

    2016-03-11

    In the U.S., young adults (18-39 year-olds) have the lowest hypertension control rates among hypertensive adults. Understanding young adults' unique perceptions about hypertension and perceived barriers to hypertension control is critical to develop effective interventions for this population. This multi-center study explored young adults': 1) emotions and reactions after a hypertension diagnosis, 2) attitudes about managing hypertension (lifestyle changes, follow-up visits, antihypertensive medication use), 3) opinions about their healthcare system's hypertension education materials, and 4) opinions about using social media to manage hypertension. Young adults (18-39 year-olds) with a diagnosis of hypertension and regular primary care access were recruited by the Wisconsin Research and Education Network (WREN). Two focus groups (one per age range: 18-29 years, 30-39 years) were conducted in three Midwestern Family Medicine Clinics (academic, rural, and urban). Conventional content analysis was performed. Thirty-eight young adults (mean: 26.7 [9.6] years old, 34% male, 45% Black, 42% with ≥1 year of college) identified barriers to managing hypertension. Emergent themes overlapped across age groups and geographic regions. Most respondents were surprised and angry about a hypertension diagnosis; they expected to develop hypertension, but at a much older age. A hypertension diagnosis negatively altered their "young" self-identity; suggested behavior changes and antihypertensive medications made them feel "older" than their peers. Young adults missed blood pressure follow-up visits due to co-payments, transportation barriers, and longer than desired wait times for brief visits. Contrary to our hypothesis, most young adults disliked social media or text messaging to support self-management; they were most concerned that their peers would see the hypertension communication. Current hypertension education materials were described as not addressing young adults' health

  8. The prevalence and correlated determinants of hypertension and type 2 diabetes: a large community-based study in Isfahan, Iran

    Maracy, M.R.; Feizi, A.; Bagherynejad, M

    2012-01-01

    Objective: Despite progress in prevention, detection, treatment and control of hypertension and diabetes, their increasing trend of prevalence remains an important public health problem. In general, only a small proportion of hypertension and diabetes is associated with an underlying disease, i.e. most cases are related to modifiable risk factors. Accordingly, as a large scale community-based study in Iran, the purpose of the present research was to evaluate the prevalence and correlated determinants of hypertension and diabetes among the general population in Isfahan. Methodology: In a cross-sectional study during 2007-2009, 3000 people aged 15-65 years were selected through multi-stage cluster random sampling from the general population in Isfahan. Total and age-sex specific prevalence of hypertension and diabetes were estimated. Multivariate logistic regression was used for studying risk factors and determining their level of association with the risk of hypertension and diabetes simultaneously. Results: The prevalence of hypertension and diabetes was 22.23% and 6.5% respectively among the studied population. Sex specific prevalence of hypertension was 22.4% and 22.06% for women and men, respectively. The corresponding values were 8.27% and 4.86% for diabetes (P < 0.05). Hypertension and diabetes were most prevalent among the age groups of 55-65 years and 45-54 years, respectively. The most important determinants of having hypertension were body mass index (BMI) (P < 0.01), age (P < 0.01), physical activity (P < 0.1) and sex (P < 0.05). Age (P < 0.01), sex (P < 0.05), BMI (P < 0.1), and family history (P < 0.01) were the major determinants of diabetes. Conclusion: The prevalence of diabetes and hypertension was high among the studied population. Furthermore, similar to previous studies, the modifiable risk factors played an important role in their incidence. Therefore, primary prevention is of high importance as a natural extension of hypertension and diabetes

  9. Sex differences in the pharmacological treatment of hypertension : a review of population-based studies

    Klungel, O.H.; de Boer, A; Paes, A.H.P.; Seidell, J C; Bakker, A

    OBJECTIVE: To summarize all available literature on sex differences in the pharmacological treatment of hypertension with respect to the percentage of hypertensive patients treated pharmacologically and the selection of antihypertensive drugs. The influences of the calendar period, age, definition

  10. Evaluation of left ventricular function in obese children without hypertension by a tissue Doppler imaging study

    Yazdan Ghandi

    2018-01-01

    Conclusions : Obesity in children without hypertension is associated with subclinical systolic and diastolic cardiac dysfunction. We propose the evaluation of blood pressure as well as myocardial performance using PWD and TDI in all obese children without hypertension, regularly.

  11. Frequency and co-prescription pattern of Chinese herbal products for hypertension in Taiwan: a Cohort study

    Yang, Pei-Rung; Shih, Wei-Tai; Chu, Yen-Hua; Chen, Pau-Chung; Wu, Ching-Yuan

    2015-01-01

    Background Chinese herbal products (CHPs) have been frequently used among patients with chronic diseases including hypertension; however, the co-prescription pattern of herbal formulae and single herbs remain uncharacterized. Thus, this large-scale pharmacoepidemiological study evaluated the frequency and co-prescription pattern of CHPs for treating hypertension in Taiwan from 2003 to 2009. Methods The database of traditional Chinese medicine (TCM) outpatient claims was obtained from the Nati...

  12. Animal models for the study of primary and secondary hypertension in humans

    Lin, Hiu Yu; Lee, Yee Ting; Chan, Yin Wah; Tse, Gary

    2016-01-01

    Hypertension is a significant cause of morbidity and mortality worldwide. It is defined as systolic and diastolic blood pressures (SBP/DBP) >140 and 90 mmHg, respectively. Individuals with an SBP between 120 and 139, or DBP between 80 and 89 mmHg, are said to exhibit pre-hypertension. Hypertension can have primary or secondary causes. Primary or essential hypertension is a multifactorial disease caused by interacting environmental and polygenic factors. Secondary causes are renovascular hyper...

  13. Tyrosine hydroxylase polymorphism (C-824T) and hypertension: a population-based study

    Nielsen, Søren J; Jeppesen, Jørgen Lykke; Torp-Pedersen, Christian

    2010-01-01

    Sympathetic nervous system (SNS) overactivity is present in a large proportion of the hypertensive population and precedes the development of established hypertension. Variations in the proximal promoter of the tyrosine hydroxylase (TH) gene have been shown to influence biochemical and physiologi......Sympathetic nervous system (SNS) overactivity is present in a large proportion of the hypertensive population and precedes the development of established hypertension. Variations in the proximal promoter of the tyrosine hydroxylase (TH) gene have been shown to influence biochemical...

  14. Ecological Study of HIV Infection and Hypertension in Sub-Saharan Africa: Is There a Double Burden of Disease?

    C Angkurawaranon

    Full Text Available Data on prevalence of hypertension were derived from a systematic search of literature published between 1975 and 2014 with corresponding national estimates on HIV prevalence and antiretroviral therapy (ART coverage from the Demographic and Health Surveys and the joint United Nations Programme on HIV/AIDS databases. National estimates on gross national income (GNI and under-five mortality were obtained from the World Bank database. Linear regression analyses using robust standard errors (allowing for clustering at country level were carried out for associations of age-standardised hypertension prevalence ratios (standardized to rural Uganda's hypertension prevalence data with HIV prevalence, adjusted for national indicators, year of study and sex of the study population.In total, 140 estimates of prevalence of hypertension representing 25 nations were sex-and area-matched with corresponding HIV prevalence. A two-fold increase in HIV prevalence was associated with a 9.29% increase in age, sex and study year-adjusted prevalence ratio for hypertension (95% CI 2.0 to 16.5, p = 0.01, which increased to 16.3% (95% CI 9.3 to 21.1 after adjusting for under-five mortality, GNI per capita and ART coverage.Countries with a pronounced burden of HIV may also have an increased burden of non-communicable diseases such as hypertension with potential economic and health systems implications.

  15. Increased mean aliphatic lipid chain length in left ventricular hypertrophy secondary to arterial hypertension: A cross-sectional study.

    Evaristi, Maria Francesca; Caubère, Céline; Harmancey, Romain; Desmoulin, Franck; Peacock, William Frank; Berry, Matthieu; Turkieh, Annie; Barutaut, Manon; Galinier, Michel; Dambrin, Camille; Polidori, Carlo; Miceli, Cristina; Chamontin, Bernard; Koukoui, François; Roncalli, Jerôme; Massabuau, Pierre; Smih, Fatima; Rouet, Philippe

    2016-11-01

    About 77.9 million (1 in 4) American adults have high blood pressure. High blood pressure is the primary cause of left ventricular hypertrophy (LVH), which represents a strong predictor of future heart failure and cardiovascular mortality. Previous studies have shown an altered metabolic profile in hypertensive patients with LVH. The goal of this study was to identify blood metabolomic LVH biomarkers by H NMR to provide novel diagnostic tools for rapid LVH detection in populations of hypertensive individuals. This cross-sectional study included 48 hypertensive patients with LVH matched with 48 hypertensive patients with normal LV size, and 24 healthy controls. Two-dimensional targeted M-mode echocardiography was performed to measure left ventricular mass index. Partial least squares discriminant analysis was used for the multivariate analysis of the H NMR spectral data. From the H NMR-based metabolomic profiling, signals coming from methylene (-CH2-) and methyl (-CH3) moieties of aliphatic chains from plasma lipids were identified as discriminant variables. The -CH2-/-CH3 ratio, an indicator of the mean length of the aliphatic lipid chains, was significantly higher (P hypertensive group without LVH and controls. Receiver operating characteristic curve showed that a cutoff of 2.34 provided a 52.08% sensitivity and 85.42% specificity for discriminating LVH (AUC = 0.703, P-value hypertension.

  16. Risk factors for the development of essential hypertension in a Mongolian population of China: a case-control study.

    Dalai, N; Cui, H; Yan, M; Rile, G; Li, S; Su, X

    2014-04-29

    Lifestyle, habits, diet, and genetics are all important factors associated with the prevalence of hypertension. Many association studies have been performed in the Chinese Han population, whereas data explaining the high prevalence of hypertension in the Mongolian population remain scarce. In the present study, we aimed to determine the factors associated with the development of essential hypertension in Mongolians. A total of 194 hypertensive cases and 201 controls from Dongwu County were enrolled in the study. Demographics, anthropometric and blood biochemical parameters, food intake, lifestyle, habits, education, occupation, and family history were recorded for each subject. Genotype and allele frequencies of six single nucleotide polymorphisms (SNPs) of the kallikrein 1 (KLK1) gene were also examined. Mean body mass index, waistline, hipline, blood sugar, blood urea nitrogen, creatinine, uric acid, total cholesterol, triglyceride, and low-density lipoprotein levels were all significantly higher in the hypertensive group (Pcontrols (Pcontrol groups (P>0.05). These results suggest that dietary history and habits have the most important influence on the development of essential hypertension in the Mongolian population.

  17. Relationship between psychosocial stress and hypertension among Ghanaians in Amsterdam, the Netherlands--the GHAIA study

    Agyei, Bernard; Nicolaou, Mary; Boateng, Linda; Dijkshoorn, Henriette; van den Born, Bert-Jan; Agyemang, Charles

    2014-01-01

    Hypertension is highly prevalent among recent sub-Saharan African (SSA) migrants in western countries and some tend to associate their hypertension to psychosocial stress. However data on the relationship between hypertension and psychosocial stress among SSA migrants are rare. We assessed the

  18. Association between anxiety and depression symptoms with resistant hypertension and central hemodynamics: A pilot study.

    Mermerelis, A

    2016-01-01

    The hypothesis that symptoms of anxiety and depression contribute to the development of hypertension has been controversial. Rutledge and Hogan found that the risk of developing hypertension is approximately 8% higher among people with psychological distress compared to those with minimal distress. People suffering from either severe depression or anxiety were two to three times more likely to develop hypertension.\\r\

  19. [Control of hypertension in nursing homes].

    Thomas, J M; Alvarez, W; Mulaj, M; De Breucker, S; Leeman, M; Pepersack, T

    2006-09-01

    In a cross sectional study we determined prevalence of hypertension among institutionalized old subjects. Prevalence of hypertension was 69%. Among detected hypertensive patients, 76% received an antihypertensive drug treatment. 61% of the declared hypertensive patients and 80% of the treated hypertensive patients had their blood pressure controlled. The general practitioners should better detect and treat this common geriatric problem associated with a high comorbidity.

  20. Increased Risk of New-Onset Hypertension After Shock Wave Lithotripsy in Urolithiasis: A Nationwide Cohort Study.

    Huang, Shi-Wei; Tsai, Chung-You; Wang, Jui; Pu, Yeong-Shiau; Chen, Pei-Chun; Huang, Chao-Yuan; Chien, Kuo-Liong

    2017-10-01

    Although shock wave lithotripsy is minimally invasive, earlier studies argued that it may increase patients' subsequent risk of hypertension and diabetes mellitus. This study evaluated the association between shock wave lithotripsy and new-onset hypertension or diabetes mellitus. The Taiwanese National Health Insurance Research Database was used to identify 20 219 patients aged 18 to 65 years who underwent the first stone surgical treatment (shock wave lithotripsy or ureterorenoscopic lithotripsy) between January 1999 and December 2011. A Cox proportional model was applied to evaluate associations. Time-varying Cox models were applied to evaluate the association between the number of shock wave lithotripsy sessions and the incidence of hypertension or diabetes mellitus. After a median follow-up of 74.9 and 82.6 months, 2028 and 688 patients developed hypertension in the shock wave lithotripsy and ureterorenoscopic lithotripsy groups, respectively. Patients who underwent shock wave lithotripsy had a higher probability of developing hypertension than patients who underwent ureterorenoscopic lithotripsy, with a hazard ratio of 1.20 (95% confidence interval, 1.10-1.31) after adjusting for covariates. The risk increased as the number of shock wave lithotripsy sessions increased. However, the diabetes mellitus risk was similar in the shock wave lithotripsy and ureterorenoscopic lithotripsy groups. Furthermore, the hazard ratio did not increase as the number of shock wave lithotripsy sessions increased. Shock wave lithotripsy consistently increased the incidence of hypertension on long-term follow-up. Therefore, alternatives to urolithiasis treatment (eg, endoscopic surgery or medical expulsion therapy) could avoid the hypertension risk. Furthermore, avoiding multiple sessions of shock wave lithotripsy could also evade the hypertension risk. © 2017 American Heart Association, Inc.

  1. Hypertension in Danish seafarers

    Tu, Mingshan; Jepsen, Jørgen Riis

    2016-01-01

    Background: Due to the high prevalence of arterial hypertension and its role in the development of athe- rosclerosis, myocardial infarction and stroke, hypertension is a major public health challenge worldwide. There is limited knowledge of the prevalence of hypertension among seafarers who......, however, are known to have an excess morbidity and mortality from these disorders. This article addresses the prevalence of hypertension among Danish seafarers and discusses potential risk factors for hypertension in maritime settings. Materials and methods: A representative sample of 629 Danish seafarers...... who had statutory medical examinations was studied from the beginning of October 2011 to the end of June 2012. The medical examination included measurements of blood pressure. The prevalence of hypertension in the study po- pulation was stratified by age, work place on board, smoking status, alcohol...

  2. The relationship of bone and blood lead to hypertension: Further analyses of the normative aging study data

    Hu, H.; Kim, Rokho; Korrick, S. [Harvard Medical School, Boston, MA (United States)]|[Harvard Health of Public Health, Boston, MA (United States); Rotnitzky, A. [Harvard School of Public Health, Boston, MA (United States)] [and others

    1996-12-31

    In an earlier report based on participants in the Veterans Administration Normative Aging Study, we found a significant association between the risk of hypertension and lead levels in tibia. To examine the possible confounding effects of education and occupation, we considered in this study five levels of education and three levels of occupation as independent variables in the statistical model. Of 1,171 active subjects seen between August 1991 and December 1994, 563 provided complete data for this analysis. In the initial logistic regression model, acre and body mass index, family history of hypertension, and dietary sodium intake, but neither cumulative smoking nor alcohol ingestion, conferred increased odds ratios for being hypertensive that were statistically significant. When the lead biomarkers were added separately to this initial logistic model, tibia lead and patella lead levels were associated with significantly elevated odds ratios for hypertension. In the final backward elimination logistic regression model that included categorical variables for education and occupation, the only variables retained were body mass index, family history of hypertension, and tibia lead level. We conclude that education and occupation variables were not confounding the association between the lead biomarkers and hypertension that we reported previously. 27 refs., 3 tabs.

  3. Does being under treatment improve knowledge attitude practice for hypertension: A hospital-based study from North India

    Rajiv Kumar Gupta

    2017-01-01

    Full Text Available Background: Studies suggest that approximately half of patients with raised blood pressure (BP are undetected, that half of those detected are not treated, and that half of those treated are not controlled, famously described as the “rule of halves.” Importantly, the cornerstone of the primary prevention of cardiovascular diseases is early detection and drug treatment (antihypertensive of patients with high BP. Studies across populations in developed world have shown that awareness and management of high BP levels are far from optimal. The present study was planned with the aim to assess the knowledge, attitude, and practices (KAP regarding hypertension in hypertensive patients visiting Tertiary Care Hospital in North-West India. Materials and Methods: Already diagnosed hypertensive patients seeking care at the tertiary care center were selected for this study. The participants were recruited using consecutive sampling technique. All participants were interviewed with the help of a semi-structured questionnaire after obtaining a written informed consent. The components of the KAP were recorded using a score sheet. Results: In all, 394 hypertensive patients of whom majority (239/394; 61% were males, were included in the study. The KAP score among the study subjects was 88.4%, 90.83%, and 95.83%, respectively. Males had higher knowledge about normal BP levels which was statistically significant (P < 0.01. Among the attitude, regular intake of anti-hypertensive drugs, regular investigations, lifestyle changes, avoidance of salt and allopathic medicines being the best for the treatment of hypertension were found to be significant statistically (P < 0.01. Conclusion: The high score among the study population can be attributed to the fact that all study participants were diagnosed patients of hypertension seeking care in a tertiary care hospital.

  4. Use of alternative medicine for hypertension in Buikwe and Mukono districts of Uganda: a cross sectional study.

    Nuwaha, Fred; Musinguzi, Geofrey

    2013-11-04

    Use of alternative medicine for chronic diseases such as hypertension is common in low as well as high income countries. This study estimated the proportion of people who were aware of their hypertension that use alternative medicine and identified factors predicting the use of alternative medicine. In a community based cross sectional survey among people ≥ 15 years in Buikwe and Mukono districts of Uganda 258 people aware of their hypertension were questioned about use of alternative medicine for hypertension, advice about uptake of life style intervention for hypertension control such as reduction of salt intake and about their attitude towards use of alternative medicine. Proportions of people who used alternative medicine and adopt life style interventions and their 95% confidence intervals (CI) were calculated. Predictors of using alternative medicine were identified using logistic binary regression analysis. More than a half 144 (56.2%) had ever used alternative medicine whereas more than one in four 74 (28.6%) were currently using alternative medicine alone or in combination with modern medicine (50%). People who were using alternative medicine alone (29.7% CI 17.5-45.9) were less likely to have received advice on reduction of salt intake compared to those using modern medicine alone or in combination with traditional medicine (56.6%, CI 47.7-65.0). The only independent predictor for using alternative medicine was agreeing that alternative medicine is effective for treatment of hypertension (adjusted odds ratio [AOR] 2.6; 95% CI 1.40-4.82). The use of alternative medicine was common among patients with hypertension and usage was underpinned by the belief that alternative medicine is effective. As patients with hypertension use alternative medicine and modern medicine concurrently, there is need for open communication between health workers and patients regarding use of alternative medicine.

  5. Race and Sex Differences of Long-Term Blood Pressure Profiles From Childhood and Adult Hypertension: The Bogalusa Heart Study.

    Shen, Wei; Zhang, Tao; Li, Shengxu; Zhang, Huijie; Xi, Bo; Shen, Hongbing; Fernandez, Camilo; Bazzano, Lydia; He, Jiang; Chen, Wei

    2017-07-01

    This study aims to characterize longitudinal blood pressure (BP) trajectories from childhood in black-white and sex groups and examine the association between childhood level-independent trajectories of BP and adult hypertension. The longitudinal cohort consisted of 2732 adults who had body mass index and BP measured 4 to 15 times from childhood (4-19 years) to adulthood (20-51 years). Model-estimated levels and linear slopes of BP and body mass index at childhood age points were calculated at 1-year intervals using the growth curve parameters and their first derivatives, respectively. Linear and nonlinear curve parameters differed significantly between race-sex groups; BP levels showed race and sex differences 15 years of age onward. Hypertensives had higher long-term BP levels than normotensives in race-sex groups. Although linear and nonlinear slope parameters of BP were race and sex specific, they differed consistently, significantly between hypertension and normotension groups. BP trajectories during young adulthood (20-35 years) were significantly greater in hypertensives than in normotensives; however, the trajectories during middle-aged adulthood (36-51 years) were significantly smaller in hypertensives than in normotensives. Level-independent linear slopes of systolic BP showed significantly negative associations (odds ratio=0.50≈0.76; P hypertension, adjusting for covariates. These associations were consistent across race-sex groups. These observations indicate that adult hypertension originates in childhood, with different longitudinal BP trajectory profiles during young and middle-aged adulthood in black-white and sex groups. Puberty is a crucial period for the development of hypertension in later life. © 2017 American Heart Association, Inc.

  6. Prevalence and risk factors of hypertension for the middle-aged population in China - results from the China Health and Retirement Longitudinal Study (CHARLS).

    Li, Zhen; Fu, Chang; Yang, Fan; Mao, Zongfu

    2018-03-19

    The prevalence of hypertension in middle-aged people is increasing. However, few studies have examined the risk factors of hypertension among the middle-aged population. The aim of this study is to present the prevalence of hypertension and its risk factors for the middle-aged population in China. The data were from the third-wave national survey (2015) of the China Health and Retirement Longitudinal Study (CHARLS). A total of 7,178 respondents aged 45-59 years were included in this study. Hypertension was defined as SBP ≥ 140 mmHg and/or DBP ≥ 90 mmHg or currently taking antihypertensive medicines. Multivariate logistic regression analyses were used to identify the risk factors of hypertension. The prevalence of hypertension was 29.12% (95%CI = 28.07-30.17). Hypertension was more prevalent among men than women (31.63% vs. 27.03%). Older age, higher BMI, chronic diseases, and poor health status were independently associated with hypertension in both genders (p < 0.05). Among women, college education (OR = 0.302, 95%CI = 0.152-0.598), marriage or cohabitation (OR = 0.756, 95%CI = 0.584-0.98), and drinking more than once a month (OR = 0.645, 95% = 0.498-0.836) led to a decreased likelihood of hypertension. Individuals with larger waist circumference were more likely to have hypertension (OR = 1.57, 95%CI = 1.294-1.906). Our results indicate that hypertension is highly prevalent in the middle-aged population in China. Men are more likely to have hypertension than women. Older age, higher BMI, chronic diseases and poor self-rated health are risk factors for hypertension in both genders. Large waist circumference, singleness, low educational level, and non-drinking are risk factors of hypertension among women but not among men.

  7. Association between exposure to noise and risk of hypertension: a meta-analysis of observational epidemiological studies.

    Fu, Wenning; Wang, Chao; Zou, Li; Liu, Qiaoyan; Gan, Yong; Yan, Shijiao; Song, Fujian; Wang, Zhihong; Lu, Zuxun; Cao, Shiyi

    2017-12-01

    An increasing amount of original studies suggested that exposure to noise could be associated with the risk of hypertension, but the results remain inconsistent and inconclusive. We aimed to synthesize available epidemiological evidence about the relationship between various types of noise and hypertension, and to explore the potential dose-response relationship between them in an up-to-date meta-analysis. We conducted a literature search of PubMed and Embase from these databases' inception through December 2016 to identify observational epidemiological studies examining the association between noise and risk of hypertension. A random effects model was used to combine the results of included studies. Dose-response meta-analysis was conducted to examine the potential dose-response relationship. In total, 32 studies (five cohort studies, one case-control study, and 26 cross-section studies) involving 264 678 participants were eligible for inclusion. Pooled result showed that living or working in environment with noise exposure was significantly associated with increased risk of hypertension (odds ratio 1.62; 95% confidence interval: 1.40-1.88). We found no evidence of a curve linear association between noise and risk of hypertension. A dose-response analysis suggested that, for an increment of per 10 dB(A) of noise, the combined odds ratio of hypertension was 1.06 (95% confidence interval: 1.04-1.08). Integrated epidemiological evidence supports the hypothesis that exposure to noise may be a risk factor of hypertension, and there is a positive dose-response association between them.

  8. Radioisotopic studies in renovascular hypertension before and after surgery or percutaneous transluminal renal angioplasty

    Mantero, F.; Fallo, F.; Scaroni, C.; Ridolfi, P.; Sicolo, M.; Varotta, L.; Bui, F.

    1987-01-01

    Over the past few years, radioisotopic studies have emerged as reliable diagnostic procedures in the screening for renovascular hypertension. More specifically, dynamic reno-scintigraphy (DRS) has been proved to be very sensitive in revealing hypoperfusion due to renal artery stenosis, although it cannot compete with the accuracy of arteriography, which only may provide a definitive diagnosis. Moreover, DRS appears to be a convenient test in clinical routine investigation because of its simplicity, low dose of tracer and high margin of safety for the patients

  9. Factors Influencing Compliance and Health Seeking Behaviour for Hypertension in Mukono and Buikwe in Uganda: A Qualitative Study.

    Musinguzi, Geofrey; Anthierens, Sibyl; Nuwaha, Fred; Van Geertruyden, Jean-Pierre; Wanyenze, Rhoda K; Bastiaens, Hilde

    2018-01-01

    Hypertension is a global public health challenge and a leading risk factor for cardiovascular morbidity and mortality. Hypertension control rates are low worldwide, and delay in seeking care is associated with increased mortality. In a qualitative study, known hypertensive patients were interviewed to explore factors influencing compliance and health seeking behaviour (HSB). Data was analyzed following a semantic thematic analysis approach. Patients sought various channels of care for their hypertension. Self-medication and access to antihypertensive drugs with or without prescription were common as well as use of herbal remedies. Regular monitoring of blood pressure was not a common practice. Factors influencing HSB were related to health systems and the patient socioeconomic and structural environment. The main system issues were related to availability and attitudes of staff and shortage of supplies and medicines. The patient factors were related to awareness, perceived severity, perceived effectiveness of therapy, adverse effects, and perceived fears of lifelong dependence on medicines. The patient socioeconomic status played a role as did the marketing of traditional medicine. Patients seek varied channels of care for their hypertension. Strategies to address the multifactorial dimensions that affect HSB are needed to improve hypertension control in this population.

  10. Factors Influencing Compliance and Health Seeking Behaviour for Hypertension in Mukono and Buikwe in Uganda: A Qualitative Study

    Geofrey Musinguzi

    2018-01-01

    Full Text Available Background and Methods. Hypertension is a global public health challenge and a leading risk factor for cardiovascular morbidity and mortality. Hypertension control rates are low worldwide, and delay in seeking care is associated with increased mortality. Methods. In a qualitative study, known hypertensive patients were interviewed to explore factors influencing compliance and health seeking behaviour (HSB. Data was analyzed following a semantic thematic analysis approach. Results. Patients sought various channels of care for their hypertension. Self-medication and access to antihypertensive drugs with or without prescription were common as well as use of herbal remedies. Regular monitoring of blood pressure was not a common practice. Factors influencing HSB were related to health systems and the patient socioeconomic and structural environment. The main system issues were related to availability and attitudes of staff and shortage of supplies and medicines. The patient factors were related to awareness, perceived severity, perceived effectiveness of therapy, adverse effects, and perceived fears of lifelong dependence on medicines. The patient socioeconomic status played a role as did the marketing of traditional medicine. Conclusion. Patients seek varied channels of care for their hypertension. Strategies to address the multifactorial dimensions that affect HSB are needed to improve hypertension control in this population.

  11. Development and Pilot Study of Group-Based Dietary Self-Management Program for Community Dwellers with Hypertension

    Arfiza Ridwan

    2012-08-01

    Full Text Available Background: In most countries worldwide, hypertension is considered as an important problem. Moreover, an increasing trend in the prevalence and incidence has been reported in most countries. This increasing trend requires an innovative approach to improve the lifestyle modification of hypertensive sufferers including their dietary behaviors. Objective: This developmental research aims to develop a program for improving the dietary behaviors of community dwellers with hypertension. Method: The process of this program development includes a literature review related to the self-management programs for hypertension, and dietary behavior outcomes, expert validation, and pilot testing. Result: The setting, strategies, duration, and outcome measurement from the literature review were taken into consideration to develop the new program. The newly developed group-based self-management program consists of: 1 the sharing and reflecting of individual current dietary behavior, 2 group educational session, 3 individual comparison of behavior and reflection of obstacles, 4 individual goal setting, and 5 follow up. In the educational session, the DASH eating plan is used as the reference as it is commonly used in studies about diet for hypertension. Key words: hypertension, self-management, group based program, dietary behaviors.

  12. Study on the relationship between serum sex hormones levels and essential hypertension

    Song Qingzhang; Yang Xiuhong; Di Fang

    2006-01-01

    Objective: To investigate the possible relationship existing between serum sex hormones levels and development of essential hypertension. Methods: Serum sex hormones (LH, FSH, E 2 , P, T) levels were determined with RIA in 87 males and 81 post-menopausal women with essential hypertension as well as in 44 normotensive males and 40 normotensive post-menopausal women serving as controls. Results: The serum E 2 , progesterone and testosterone levels in the hypertensives were significantly higher than those in the respective controls (P 0.05). Sex hormones levels were not much different among hypertensives of various stages (I , II, III). The serum E 2 levels in male hypertensives and progesterone levels in female hypertensives were not correlated with the respective FSH and LH levels. Conclusion: The authors suggested that the changes of serum sex hormones levels might be a risk factor rather than a consequence of the development of essential hypertension. (authors)

  13. Pulmonary Hypertension

    Kim, John S.; McSweeney, Julia; Lee, Joanne; Ivy, Dunbar

    2015-01-01

    Objective Review the pharmacologic treatment options for pulmonary arterial hypertension (PAH) in the cardiac intensive care setting and summarize the most-recent literature supporting these therapies. Data Sources and Study Selection Literature search for prospective studies, retrospective analyses, and case reports evaluating the safety and efficacy of PAH therapies. Data Extraction Mechanisms of action and pharmacokinetics, treatment recommendations, safety considerations, and outcomes for specific medical therapies. Data Synthesis Specific targeted therapies developed for the treatment of adult patients with PAH have been applied for the benefit of children with PAH. With the exception of inhaled nitric oxide, there are no PAH medications approved for children in the US by the FDA. Unfortunately, data on treatment strategies in children with PAH are limited by the small number of randomized controlled clinical trials evaluating the safety and efficacy of specific treatments. The treatment options for PAH in children focus on endothelial-based pathways. Calcium channel blockers are recommended for use in a very small, select group of children who are responsive to vasoreactivity testing at cardiac catheterization. Phosphodiesterase type 5 inhibitor therapy is the most-commonly recommended oral treatment option in children with PAH. Prostacyclins provide adjunctive therapy for the treatment of PAH as infusions (intravenous and subcutaneous) and inhalation agents. Inhaled nitric oxide is the first line vasodilator therapy in persistent pulmonary hypertension of the newborn, and is commonly used in the treatment of PAH in the Intensive Care Unit (ICU). Endothelin receptor antagonists have been shown to improve exercise tolerance and survival in adult patients with PAH. Soluble Guanylate Cyclase Stimulators are the first drug class to be FDA approved for the treatment of chronic thromboembolic pulmonary hypertension. Conclusions Literature and data supporting the

  14. Noncirrhotic portal hypertension.

    Da, Ben L; Koh, Christopher; Heller, Theo

    2018-05-01

    Noncirrhotic portal hypertension represents a heterogeneous group of liver disorders that is characterized by portal hypertension in the absence of cirrhosis. The purpose of this review is to serve as a guide on how to approach a patient with noncirrhotic portal hypertension with a focus on recent developments. Recent studies pertaining to noncirrhotic portal hypertension have investigated aetiological causes, mechanisms of disease, noninvasive diagnostic modalities, clinical characteristics in the paediatric population and novel treatment targets. Noncirrhotic portal hypertension is an underappreciated clinical entity that can be difficult to diagnosis without a healthy suspicion. Diagnosis then relies on a comprehensive understanding of the causes and clinical manifestations of this disease, as well as a careful interpretation of the liver biopsy. Noninvasive approaches to diagnosis may play a significant role moving forward in this disease. Treatment in NCPH remains largely targeted at the individual sequalae of portal hypertension.

  15. [Physician knowledge and attitudes on the clinical evaluation and treatment of resistant hypertension: The RESIST study].

    Coca, A

    Resistant hypertension (RH) is associated with a high risk of cardiovascular and renal complications. The purpose of this study was to assess the knowledge and attitudes of Primary Care physicians, general medicine doctors, and clinical cardiologists on the management of this condition. A multicentre, descriptive, observational study based on an ad hoc questionnaire distributed to Primary Care physicians (n=1017) and general medicine physicians/clinical cardiologists (n=457). To establish the diagnosis of resistant hypertension, 69.1% of physicians confirm that systolic/diastolic blood pressure is above 140/90 mmHg, despite treatment. Furthermore, 64.9% only consider this diagnosis if the patient is treated with at least 3 medications, and 50.3% also requires that one of them is a thiazide diuretic (56.7% among specialists, P=.0004). To establish a definite diagnosis of true RH, 89.6% perform 24-h ambulatory blood pressure monitoring (93.3% of specialists, P=.0017), looking specifically for «white-coat» effect in 70.2% of cases. In addition, 79.3% verify that adherence to treatment is adequate. Between 87 and 95% of physicians indicate examinations to exclude causes of secondary hypertension. Up to 54.3% of physicians (71.3% specialists, P<.0001) consider adding a fourth drug and insisting on lifestyle interventions as a priority therapeutic measure. These data show that physician knowledge regarding the management of patients with RH is good. Interestingly, this knowledge is somewhat higher among specialists than among Primary Care physicians. Copyright © 2016 SEH-LELHA. Publicado por Elsevier España, S.L.U. All rights reserved.

  16. Work stress related lipid disorders and arterial hypertension in professional drivers: A cross-sectional study

    Đinđić Nataša

    2013-01-01

    Full Text Available Background/Aim. Occupational stress is a term used to define ongoing stress that is related to the workplace. The study was conducted to determine association of occupational stress index (OSI and its aspects with arterial hypertension and lipid disorders using data from a cross-sectional survey of male professional drivers. Methods. The cross-sectional study was performed in 439 professional drivers divided into groups (city- and intercity bus drivers, truck and taxi drivers. The OSI and OSI aspects (high demands, strictness, underload, extrinsic time pressure, noxious exposure, avoidance and conflict were calculated using the standardized questionnaire. Determination of serum lipids, blood pressure (BP and cardiovascular risk factors were done. Results. A significant difference in prevalence of diagnosed hypertension and dyslipidemia was found along with a difference in total OSI and OSI aspects among examined subgroups of drivers. A total OSI was highest in city, high in intercity bus drivers, and the lowest one in truck and taxi drivers (82.79 ± 3.5, 81.28 ± 3.7, 73.75 ± 3.5, 71.61 ± 4.4, respectively; p < 0.01. Similar pattern showed triglycerides (TG, total cholesterol (TC and LDL cholesterol and BP, while HDL-cholesterol showed reverse order (p < 0.01. Logistic regression analyses with multiple OSI aspects adjusted for age and years of exposure showed associations of total OSI with arterial hypertension [OR 5.5; 95% CI (2.24-7.95] and dyslipidemia [OR 1.43 95% CI (1.09-2.80]. Underload was the most important OSI aspect associated with the arterial hypertension [OR 1.18; 95% CI (1.04-2.58] and elevated LDL cholesterol [1.26; 95 CI (1.19-2.1]. A total OSI had a significant association with elevated LDL cholesterol [2.64; 95% CI (1.19- 7.7], triglycerides [OR 3.27; 95% CI (1.20-5.1] and low HDL cholesterol [OR 3.29; 95% CI (1.8-5.8] (p < 0.01. Conclusion. The study provides the evidence for the significant association of total OSI and

  17. Hypertensive Crisis

    ... Artery Disease Venous Thromboembolism Aortic Aneurysm More Hypertensive Crisis: When You Should Call 9-1-1 for ... Nov 13,2017 A hypertensive ( high blood pressure ) crisis is when blood pressure rises quickly and severely ...

  18. Prevalence, awareness, medication, control, and risk factors associated with hypertension in Bai ethnic group in rural China: the Yunnan Minority Eye Study.

    Zhang, Jinman; Huang, Qin; Yu, Minbin; Cha, Xueping; Li, Jun; Yuan, Yuansheng; Wei, Tao; Zhong, Hua

    2013-01-01

    This study aimed to assess the prevalence, awareness, treatment, and control of hypertension and their associated factors among Bai ethnic population in the rural China. A population-based survey was conducted in 2010 with a randomly cluster sampling in rural communities in Dali, southwest China. A total of 2133 adults aged 50 or above were interviewed, and their blood pressure, height, weight and waist circumference were measured. Hypertension was defined as a mean SBP≥140 mmHg and/or DBP≥90 mmHg, and/or current use of antihypertensive medications. The prevalence of hypertension was 42.1% (899/2133), and the age- and gender-adjusted prevalence was 40.0%. Among the hypertensive participants, 28.4% (255/899)were aware of their condition, while 24.6% (221/899) took antihypertensive medications, with only 7.5% (67/899) of those achieving blood pressure control (population of Bai ethnic group in China, while the associated risk factors of hypertension include overweight/obesity, cigarette smoking, history of hypertension, and older age. The percentages of hypertensive participants aware of their hypertension and those taking antihypertensive medications were low with an incredibly low proportion of hypertensive patients who kept their hypertension under control. It is suggested that health education and hypertension screening programs be carried out in the area for the high blood pressure prevention and control.

  19. Prognostic importance of hemoglobin in hypertensive patients with electrocardiographic left ventricular hypertrophy: the Losartan Intervention For End point reduction in hypertension (LIFE) study

    Olsen, Michael Hecht; Wachtell, Kristian; Beevers, Gareth

    2008-01-01

    BACKGROUND: The prognostic importance of hemoglobin is controversial. We investigated the prognostic importance of baseline and in-treatment hemoglobin in the LIFE study. METHODS: Eight thousand one hundred ninety-four LIFE patients with hypertension and left ventricular hypertrophy with available...... with the same gender-specific definitions for high and low hemoglobin as time-varying covariates with adjustment for treatment allocation and established risk factors and diseases, hemoglobin in the lowest decile was associated with higher rates of all-cause mortality (HR 3.03, 95% CI 1.89-4.85, P

  20. [Cardiovascular risk profile of uncontrolled hypertensive patients. The Control-Project study].

    Márquez-Contreras, Emilio; Coca, Antonio; de la Figuera von Wichmann, Mariano; Divisón, Juan Antonio; Llisterri, José Luis; Sobrino, Javier; Filozof, Claudia; Sánchez-Zamorano, Miguel Angel; Grigorian Shamagian, Lilian

    2007-01-27

    To assess absolute cardiovascular risk and co-morbidities in uncontrolled hypertensive patients (blood pressure [BP]>or=140/90 mmHg or>or=130/80 mmHg in diabetics) attending Primary Care Physicians in Spain, and to determine the attitudes of these physicians towards this problem. Cross-sectional, multicenter study involving 356 general practitioners around Spain. Absolute cardiovascular risk was assessed according to ESH-ESC 2003 Guidelines in a sample of 1,710 patients. Two hundred ninety seven patients were excluded by several reasons and a total of 1,413 hypertensive patients were valuable (mean age: 65.3+/-11.4 years; 56.7% women). Normal BP values (or=180/110 mmHg) by 7.9%. Associated cardiovascular risk factors were observed in 96.0% of patients (95% CI=94.7-97.2%), target organ damage in 34.5% (95% CI=31.6-36.5%), and cardiovascular clinical disease in 36.0% (95% CI=33.5-38.5%). According to ESH-ESC 2003 Guidelines 34.0% (CI=31.5-38.2%) were at very-high risk; 29.4% (95% CI=26.4-32.8%) at high risk; 30.4% (95% CI=27.2-33.7%) at moderate risk and 5.4% (95% CI=3.9-7.2%) at low risk of cardiovascular disease. Despite the high absolute risk, physicians did not do any therapeutic change in 30.4% (95% CI=28.2-33.5%) of uncontrolled hypertensive patients. Most of them (64.26%) considered that bad compliance to life style changes was the reason for inadequate BP control. The most frequent measure introduced was the association of additional drugs. Absolute cardiovascular risk in uncontrolled hypertensive patients attending Primary Care Physicians in Spain is very relevant. Sixty-five percent of these patients are at high or very high risk with a high prevalence of target organ damage or associated cardiovascular clinical disease. Therapeutic attitudes towards these patients are still very conservative although they are improving compared with previous studies.

  1. Increased dementia risk predominantly in diabetes mellitus rather than in hypertension or hyperlipidemia: a population-based cohort study.

    Fan, Yen-Chun; Hsu, Jung-Lung; Tung, Hong-Yi; Chou, Chia-Chi; Bai, Chyi-Huey

    2017-02-06

    The pathophysiology of insulin resistance-induced hypertension and hyperlipidemia might entail differences in dementia risk in cases with hypertension and hyperlipidemia without prior diabetes mellitus (DM). This study investigated whether incident hypertension, incident hyperlipidemia, or both, increased the dementia risk in patients with and without DM. A nationwide retrospective cohort study was conducted. The study sample was obtained from the National Health Insurance Research Database. We enrolled 10,316 patients with a new diagnosis of DM between 2000 and 2002 in the DM cohort. For the same period, we randomly selected 41,264 patients without DM in the non-DM cohort (matched by age and sex at a 1:4 ratio with the DM cohort). Both cohorts were then separately divided into four groups on the basis of incident hypertension or incident hyperlipidemia status. In total, 51,580 patients aged between 20 and 99 years were enrolled. The dementia risk was higher in the DM cohort than in the non-DM cohort (adjusted hazard ratio (HR) = 1.47, 95% confidence interval (CI) = 1.30-1.67, p hypertension and hyperlipidemia did not significantly increase compared with that in those without hypertension and hyperlipidemia (p = 0.529). Similar results were observed in those with either hypertension (p = 0.341) or hyperlipidemia (p = 0.189). In the non-DM cohort, patients with both hypertension and hyperlipidemia had a higher dementia risk (adjusted HR = 1.33, 95% CI = 1.09-1.63, p = 0.006). The results remained largely unchanged in patients with only hypertension (adjusted HR = 1.22, 95% CI = 1.05-1.40, p = 0.008). However, the dementia risk did not increase significantly in patients with only hyperlipidemia (p = 0.187). The development of hypertension, hyperlipidemia, or both, following a diagnosis of incident diabetes is secondary to diabetes onset and likely mediated through insulin resistance associated with diabetes, which

  2. The role of the autonomic nervous system in hypertension: a bond graph model study

    Chen, Shuzhen; Gong, Yuexian; Dai, Kaiyong; Sui, Meirong; Yu, Yi; Ning, Gangmin; Zhang, Shaowen

    2008-01-01

    A bond graph model of the cardiovascular system with embedded autonomic nervous regulation was developed for a better understanding of the role of the autonomic nervous system (ANS) in hypertension. The model is described by a pump model of the heart and a detailed representation of the head and neck, pulmonary, coronary, abdomen and extremity circulation. It responds to sympathetic and parasympathetic activities by modifying systemic peripheral vascular resistance, heart rate, ventricular end-systolic elastance and venous unstressed volumes. The impairment of ANS is represented by an elevation of the baroreflex set point. The simulation results show that, compared with normotensive, in hypertension the systolic and diastolic blood pressure (SBP/DBP) rose from 112/77 mmHg to 144/94 mmHg and the left ventricular wall thickness (LVWT) increased from 10 mm to 12.74 mm. In the case that ANS regulation was absent, both the SBP and DBP further increased by 8 mmHg and the LVWT increased to 13.22 mm. The results also demonstrate that when ANS regulation is not severely damaged, e.g. the baroreflex set point is 97 mmHg, it still has an effect in preventing the rapid rise of blood pressure in hypertension; however, with the worsening of ANS regulation, its protective role weakens. The results agree with human physiological and pathological features in hemodynamic parameters and carotid baroreflex function curves, and indicate the role of ANS in blood pressure regulation and heart protection. In conclusion, the present model may provide a valid approach to study the pathophysiological conditions of the cardiovascular system and the mechanism of ANS regulation

  3. Evaluation of left ventricular function in obese children without hypertension by a tissue Doppler imaging study.

    Ghandi, Yazdan; Sharifi, Mehrzad; Habibi, Danial; Dorreh, Fatemeh; Hashemi, Mojtaba

    2018-01-01

    The prevalence of obesity is increasing worldwide. Obese children without hypertension are becoming an important health challenge. Complications of obesity in adults are well established, but in obese children, cardiac dysfunction has not been reported clinically. The present crosssectional study investigates subclinical systolic and diastolic dysfunction using echocardiographic modalities. Twentyfive youngsters with body mass index (BMI) >30 and 25 healthy children with BMI <25 were assigned into case and control group, respectively. In all participants, complete cardiovascular examination, electrocardiography, and echocardiography were fulfilled. Echocardiography surveys included standard, pulsed wave Doppler (PWD), and tissue Doppler imaging (TDI). SPSS software, version 24. The two groups were matched for age and sex. The resting heart rate and blood pressure were markedly higher in the obese group ( P = 0.0001) though they were within the normal range in either category. Ejection fraction in the two groups was similar. Left ventricular (LV) mass ( P = 0.0001), LV mass index ( P = 0.029), left atrialtoaortic diameter ratio ( P = 0.0001), and LV enddiastolic diameter ( P = 0.008) were significantly greater in the case group, indicating cardiomegaly and subclinical systolic and diastolic dysfunction. Except for the aortic velocity, all PWD variables were considerably lower in the case group, suggesting subclinical diastolic dysfunction. All TDI parameters varied significantly between the two categories. There was a direct correlation between isovolumetric relaxation time and BMI. Obesity in children without hypertension is associated with subclinical systolic and diastolic cardiac dysfunction. We propose the evaluation of blood pressure as well as myocardial performance using PWD and TDI in all obese children without hypertension, regularly.

  4. A Study on Renin-Angiotensin System and Total Exchangeable Sodium in Hypertension

    Choe, Kang Won; Park, Jung Sik; Lee, Jung Sang; Koh, Chang Soon

    1976-01-01

    The etiologic role of renin-angiotensin system and sodium-volume status in the pathophysiology of various forms of hypertension was investigated. Plasma renin activity (PRA) was measured by radioimmunoassay, while sodium-volume status was evaluated by the determination of total exchangeable sodium(NaE) using isotope dilution method. The subjects consisted of 25 controls, 24 patients with essential hypertension, 22 patients with chronic renal failure (13 with hypertension, 9 without hypertension) and 14 patients with malignant hypertension. The results were as follows: 1) An inverse correlation between NaE and PRA was noted in control subjects (r=-0.598, p 0.1) 3) Absolute value of PRA was not deviated significantly from control group (2.53±1.416 ng/ml/hr) except in malignant hypertension (6.09±2.042, p 0.1). It is suggested that renin-angiotensin system plays a predominant role in the pathogenesis of malignant hypertension and in hypertension of chronic renal failure, though sodium retention is also contributing factor. PRA variation in essential hypertension does not appear to be associated with any consistent change in Na-volume status, suggesting the existence of another mechanism in the genesis of hypertension and PRA variation.

  5. Short-term variability and nocturnal decline in ambulatory blood pressure in normotension, white-coat hypertension, masked hypertension and sustained hypertension: a population-based study of older individuals in Spain.

    Gijón-Conde, Teresa; Graciani, Auxiliadora; López-García, Esther; Guallar-Castillón, Pilar; García-Esquinas, Esther; Rodríguez-Artalejo, Fernando; Banegas, José R

    2017-06-01

    Blood pressure (BP) variability and nocturnal decline in blood pressure are associated with cardiovascular outcomes. However, little is known about whether these indexes are associated with white-coat and masked hypertension. We performed a cross-sectional analysis of 1047 community-dwelling individuals aged ⩾60 years in Spain in 2012. Three observer-measured home BPs and 24-h ambulatory blood pressure monitoring (ABPM) were performed under standardized conditions. BP variability was defined as BP s.d. and coefficient of variation. Differences in BP variability and nocturnal BP decrease between groups were adjusted for sociodemographic and clinical covariates using generalized linear models. Of the cohort, 21.7% had white-coat hypertension, 7.0% had masked hypertension, 21.4% had sustained hypertension, and 49.9% were normotensive. Twenty-four hour, daytime and night-time systolic BP s.d. and coefficients of variation were significantly higher in subjects with white-coat hypertension than those with normotension (Pcoat hypertension than in those with normotension (Pcoat hypertension group and lowest in the masked hypertension group in all patients and untreated patients (Pcoat hypertension, 78.1% of subjects with masked hypertension, and 72.2% of subjects with sustained hypertension (Pcoat hypertension and blunted nocturnal BP decrease was observed more frequently in subjects with masked hypertension. These findings may help to explain the reports of increased cardiovascular risk in patients with white-coat hypertension and poor prognosis in those with masked hypertension, highlighting the importance of ABPM.

  6. Accelerometer-determined physical activity and all-cause mortality in a national prospective cohort study of hypertensive adults.

    Loprinzi, Paul D

    2016-05-01

    Research in the general population suggests an inverse association between physical activity and all-cause mortality. Less research on this topic has been conducted among hypertensive adults, but the limited studies also suggest an inverse association between physical activity and all-cause mortality among hypertensive adults. At this point, sex-specific differences are not well understood, and all of the physical activity-mortality studies among hypertensive adults have employed a self-report measure of physical activity. Therefore, the purpose of this study was to examine the sex-specific association between objectively measured physical activity and all-cause mortality among a national sample of hypertensive adults. Data from the 2003 to 2006 National Health and Nutrition Examination Survey, with follow-up through 2011, were employed. Hypertension status was defined using measured blood pressure and use of blood pressure-lowering medication. Physical activity was assessed via accelerometry. After adjustments, for every 60-min increase in physical activity, hypertensive adults had a 19% (hazard rate = 0.81; 95% confidence interval: 0.72-0.91) reduced risk of all-cause mortality. There was also evidence of a dose-response relationship. Compared with those in the lowest tertile, those in the middle and upper tertiles had a 31 and 42% reduced all-cause mortality risk, respectively. There was no evidence of a sex-specific interaction effect. Among hypertensive adults, objectively measured physical activity is associated with all-cause mortality risk in a dose-response manner.

  7. Captopril as a replacement for multiple therapy in hypertension: a controlled study.

    Yodfat, Y; Fidel, J; Bloom, D S

    1985-11-01

    A controlled study was conducted in hypertensive patients to investigate whether captopril can be substituted for the various other antihypertensive drugs (not including diuretics) to reduce side effects and improve the quality of life. Captopril in a twice daily dose of 25-50 mg, was substituted and titrated in 54 patients. Fifty-two patients, matched by age and sex, comprised the control group, and were treated with a variety of agents. During a follow-up of 9 months, 44 of the patients receiving captopril (81%) achieved the goal of supine blood pressure less than 90 mmHg. Captopril was discontinued in two patients due to side effects. Mild proteinuria was observed in two patients. A significant reduction in scores or rates of side effects (numbness, blurred vision, insomnia, vivid dreams, cold extremities, sleepiness, sexual dysfunction and fatigue) and improvement in quality of life (general feeling, mood and concentration) was observed in the study group compared with the control group. Captopril alone in a twice daily dose of 25-50 mg, or in co-treatment with thiazide, provided sustained blood pressure control with minimal side effects and improvement in quality of life compared with the treatment of hypertension with beta-blockers, vasodilators or methyldopa.

  8. The Cost-Effectiveness of Low-Cost Essential Antihypertensive Medicines for Hypertension Control in China: A Modelling Study.

    Dongfeng Gu

    2015-08-01

    cardiovascular disease for secondary prevention was projected to be cost saving in the main simulation and 100% of probabilistic simulation results. Treating all hypertension for primary and secondary prevention would prevent about 800,000 cardiovascular disease events annually (95% uncertainty interval, 0.6 to 1.0 million and was borderline cost-effective incremental to treating only cardiovascular disease and stage two patients (2015 Int$13,000 per QALY gained [95% uncertainty interval, Int$10,000 to Int$18,000]. Of all one-way sensitivity analyses, assuming adherence to taking medications as low as 25%, high Shanghai drug costs, or low medication efficacy led to the most unfavorable results (treating all hypertension, about Int$47,000, Int$37,000, and Int$27,000 per QALY were gained, respectively. The strengths of this study were the use of a recent Chinese national health survey, vital statistics, health care costs, and cohort study outcomes data as model inputs and reliance on clinical-trial-based estimates of coronary heart disease and stroke risk reduction due to antihypertensive medication treatment. The limitations of the study were the use of several sources of data, limited clinical trial evidence for medication effectiveness and harms in the youngest and oldest age groups, lack of information about geographic and ethnic subgroups, lack of specific information about indirect costs borne by patients, and uncertainty about the future epidemiology of cardiovascular diseases in China.Expanded hypertension treatment has the potential to prevent about 800,000 cardiovascular disease events annually and be borderline cost-effective in China, provided low-cost essential antihypertensive medicines programs can be implemented.

  9. Relationship between brain atrophy estimated by a longitudinal computed tomography study and blood pressure control in patients with essential hypertension

    Yamano, Shigeru; Sawai, Fuyuki; Yamamoto, Yuta [Nara Medical Univ., Kashihara (Japan)] [and others

    1999-01-01

    To evaluate the relationship between blood pressure control and the progression of brain atrophy in the elderly, patients with essential hypertension and brain atrophy were longitudinally evaluated using computerized tomography (CT). The study evaluated 48 patients with essential hypertension aged 46-78 years, and 30 sex- and age-matched normotensive control subjects. The extent of brain atrophy as determined by caudate head index (CHI), the inverse cella media index (iCMI), and Evans` ratio (ER) was estimated twice at an interval of 5-9 years (mean, 6.9 years). The mean annual increases in CHI ({Delta}CHI), iCMI ({Delta}iCMI), and ER ({Delta}ER) were evaluated. Mean blood volume in the common carotid artery (BF) and the decrease in BF per year ({Delta}BF) were also determined. The {Delta}CHI, {Delta}iCMI, and {Delta}ER increased with age in the hypertensive subjects as well as the control group across all age groups evaluated. The {Delta}CHI, {Delta}iCMI, and {Delta}ER were significantly greater in the patients with essential hypertension in their 50s as compared with the controls. In patients with essential hypertension aged 65 years or older, the {Delta}CHI, {Delta}iCMI, and {Delta}ER were significantly lower in the group in whom the blood pressure was controlled within the range of borderline hypertension than the groups in which it was controlled in the range of normal or mild hypertension. In the younger patients under the age of 65 with essential hypertension, blood pressure control did not affect the {Delta}CHI, {Delta}iCMI, and {Delta}ER. The {Delta}CHI, {Delta}iCMI, and {Delta}ER were significantly correlated with {Delta}BF in both groups. These findings indicate that control of systolic blood pressure within the range of borderline hypertension may delay the progression of brain atrophy in elderly patients with essential hypertension. (author)

  10. Relationship between brain atrophy estimated by a longitudinal computed tomography study and blood pressure control in patients with essential hypertension

    Yamano, Shigeru; Sawai, Fuyuki; Yamamoto, Yuta

    1999-01-01

    To evaluate the relationship between blood pressure control and the progression of brain atrophy in the elderly, patients with essential hypertension and brain atrophy were longitudinally evaluated using computerized tomography (CT). The study evaluated 48 patients with essential hypertension aged 46-78 years, and 30 sex- and age-matched normotensive control subjects. The extent of brain atrophy as determined by caudate head index (CHI), the inverse cella media index (iCMI), and Evans' ratio (ER) was estimated twice at an interval of 5-9 years (mean, 6.9 years). The mean annual increases in CHI (ΔCHI), iCMI (ΔiCMI), and ER (ΔER) were evaluated. Mean blood volume in the common carotid artery (BF) and the decrease in BF per year (ΔBF) were also determined. The ΔCHI, ΔiCMI, and ΔER increased with age in the hypertensive subjects as well as the control group across all age groups evaluated. The ΔCHI, ΔiCMI, and ΔER were significantly greater in the patients with essential hypertension in their 50s as compared with the controls. In patients with essential hypertension aged 65 years or older, the ΔCHI, ΔiCMI, and ΔER were significantly lower in the group in whom the blood pressure was controlled within the range of borderline hypertension than the groups in which it was controlled in the range of normal or mild hypertension. In the younger patients under the age of 65 with essential hypertension, blood pressure control did not affect the ΔCHI, ΔiCMI, and ΔER. The ΔCHI, ΔiCMI, and ΔER were significantly correlated with ΔBF in both groups. These findings indicate that control of systolic blood pressure within the range of borderline hypertension may delay the progression of brain atrophy in elderly patients with essential hypertension. (author)

  11. STUDY OF LIPOPROTEIN (A LEVELS AS A RISK FACTOR IN PATIENTS WITH ESSENTIAL HYPERTENSION IN A TERTIARY CARE HOSPITAL

    Arun S. Menon

    2016-06-01

    Full Text Available BACKGROUND Lipoprotein (a has been identified as an important, independent, causal risk factor for various cardiovascular diseases, but its association with hypertension has shown differing results. The studies regarding this association are limited. AIMS AND OBJECTIVES In the present study, the levels of Lp (a and other lipid parameters like Serum Total Cholesterol, Serum LDL Cholesterol, Serum HDL Cholesterol, serum triglycerides have been studied in hypertensive and non-hypertensive patients to investigate any significant relationship between the same. MATERIALS AND METHODS 30 essential hypertensive patients were selected and were compared with 30 controls matched in terms of age and sex. Lipid profile including Total cholesterol, LDL- Cholesterol, HDL- Cholesterol, Triglycerides and Lp (a were studied in both groups. RESULTS Hypertensive patients were observed to have higher levels of Serum Total Cholesterol, Serum Triglycerides, Serum LDL cholesterol, but it was not found to be significant. But lipoprotein (a was found to be significantly higher (p<0.01 in cases than in controls.

  12. Efficacy of moxibustion for pre- or stage I hypertension: study protocol for a pilot randomized controlled trial

    Shin Kyung-Min

    2012-10-01

    Full Text Available Abstract Background Hypertension is a risk factor for cardiovascular disease, and the prevalence of hypertension tends to increase with age. Current treatments for hypertension have adverse side effects and poor adherence. The purpose of this study is to evaluate the effects of moxibustion on blood pressure in individuals with pre- or stage I hypertension. Methods/design Forty-five subjects with pre- or stage I hypertension will be randomized into three groups: treatment group A (2 times/week, treatment group B (3 times/week, and the control group (non-treated group. The inclusion criteria will be as follows: (1 aged between 19 and 65 years; (2 prehypertension or stage I hypertension (JNC 7, Seventh Report of the Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of High Blood Pressure; (3 the participants are volunteers and written consent obtained. The participants in the treatment group A will undergo indirect moxibustion 2 times per week for 4 weeks, and the participants in the treatment group B will undergo indirect moxibustion 3 times per week for 4 weeks. The participants in the control group (non-treated group will maintain their current lifestyle, including diet and exercise. The use of antihypertensive medication is not permitted. The primary endpoint will be a change in patient blood pressure. The secondary endpoints will be the body mass index, lipid profile, EuroQol and Heart Rate Variability. The data will be analyzed with the Student’s t-test and analysis of variance (ANOVA (p Discussion The results of this study will help to establish the optimal approach for the care of adults with pre- or stage I hypertension. Trial registration Clinical Research Information Service KCT0000469

  13. Association between Polyphenol Intake and Hypertension in Adults and Older Adults: A Population-Based Study in Brazil.

    Andreia Machado Miranda

    Full Text Available Hypertension is an important risk factor for cardiovascular disease, and diet has been identified as a modifiable factor for preventing and controlling hypertension. Besides, epidemiological studies have suggested an inverse association between polyphenol intake and cardiovascular diseases. The aim of this study was to evaluate the association between the intake of polyphenols and hypertension in a general population of Sao Paulo.Data came from the 'Health Survey of Sao Paulo (ISA-Capital' among 550 adults and older adults in Sao Paulo, Brazil. Diet was assessed by two 24-hour dietary recalls (24HR. Usual intakes were calculated using the Multiple Source Method. Polyphenol intake was calculated by matching food consumption data from the 24HR with the Phenol-Explorer database. The associations between the hypertension and tertiles of the total and classes of polyphenols intake were tested by multivariate logistic regression analysis.After multivariate adjustment for potential confounding factors the findings showed an inverse and linearly association between the hypertension and highest tertiles of tyrosols (OR = 0.33; 95%CI 0.18, 0.64, alkylphenols (OR = 0.45; 95%CI 0.23, 0.87, lignans (OR = 0.49; 95%CI 0.25, 0.98, as well as stilbenes (OR = 0.60; 95%CI 0.36, 0.98, and other polyphenols (OR = 0.33; 95%CI 0.14, 0.74. However, total polyphenol intake, and phenolic acids were significantly associated only in the middle tertile with hypertension and flavonoids were not significant associated.There is an inverse and linearly association between the highest tertile of some classes of polyphenols, such as, tyrosols, alkylphenols, lignans, stilbenes, other polyphenols and hypertension.

  14. 10-Year cardiovascular event risks for women who experienced hypertensive disorders in late pregnancy: the HyRAS study

    Ponjee Gabrielle

    2010-06-01

    Full Text Available Abstract Background Cardiovascular disease is the cause of death in 32% of women in the Netherlands. Prediction of an individual's risk for cardiovascular disease is difficult, in particular in younger women due to low sensitive and specific tests for these women. 10% to 15% of all pregnancies are complicated by hypertensive disorders, the vast majority of which develop only after 36 weeks of gestation. Preeclampsia and cardiovascular disease in later life show both features of "the metabolic syndrome" and atherosclerosis. Hypertensive disorders in pregnancy and cardiovascular disease may develop by common pathophysiologic pathways initiated by similar vascular risk factors. Vascular damage occurring during preeclampsia or gestational hypertension may contribute to the development of future cardiovascular disease, or is already present before pregnancy. At present clinicians do not systematically aim at the possible cardiovascular consequences in later life after a hypertensive pregnancy disorder at term. However, screening for risk factors after preeclampsia or gestational hypertension at term may give insight into an individual's cardiovascular risk profile. Methods/Design Women with a history of preeclampsia or gestational hypertension will be invited to participate in a cohort study 2 1/2 years after delivery. Participants will be screened for established modifiable cardiovascular risk indicators. The primary outcome is the 10-year cardiovascular event risk. Secondary outcomes include differences in cardiovascular parameters, SNP's in glucose metabolism, and neonatal outcome. Discussion This study will provide evidence on the potential health gains of a modifiable cardiovascular risk factor screening program for women whose pregnancy was complicated by hypertension or preeclampsia. The calculation of individual 10-year cardiovascular event risks will allow identification of those women who will benefit from primary prevention by tailored

  15. Alveolar bone healing process in spontaneously hypertensive rats (SHR). A radiographic densitometry study.

    Manrique, Natalia; Pereira, Cassiano Costa Silva; Garcia, Lourdes Maria Gonzáles; Micaroni, Samuel; Carvalho, Antonio Augusto Ferreira de; Perri, Sílvia Helena Venturoli; Okamoto, Roberta; Sumida, Doris Hissako; Antoniali, Cristina

    2012-01-01

    Hypertension is one of the most important public health problems worldwide. If undiagnosed or untreated, this pathology represents a systemic risk factor and offers unfavorable conditions for dental treatments, especially those requiring bone healing. The purpose of this study was to demonstrate, by analysis of bone mineral density (BMD), that the alveolar bone healing process is altered in spontaneously hypertensive rats (SHRs). Wistar rats and SHRs were submitted to extraction of the upper right incisor and were euthanized 7, 14, 21, 28 and 42 days after surgery. Right maxillae were collected, radiographed and analyzed using Digora software. BMD was expressed as minimum (min), middle (med) and maximum (max) in the medium (MT) and apical (AT) thirds of the dental alveolus. The results were compared across days and groups. Wistar showed difference in med and max BMD in the MT between 7 and 28 and also between 14 and 28 days. The AT exhibited significant difference in med and min BMD between 7 and 28 days, as well as difference in min BMD between 28 and 42 days. SHRs showed lower med BMD in the MT at 28 days when compared to 21 and 42 days. Differences were observed across groups in med and min BMD at day 28 in the MT and AT; and in max BMD at 14, 21 and 42 days in the MT. These results suggest that the alveolar bone healing process is delayed in SHRs comparing with Wistar rats.

  16. Grape Seed Procyanidins in Pre- and Mild Hypertension: A Registry Study

    Gianni Belcaro

    2013-01-01

    Full Text Available The efficacy of a standardized grape seed procyanidins extract (GSPE, Enovita to decrease blood pressure when associated with nondrug intervention (diet and lifestyle modifications was investigated in a controlled registry study involving 119 healthy, pre- and mildly hypertensive subjects. Two dosages of Enovita were evaluated (150 and 300 mg/die, using blood pressure and heart rate as the primary endpoints and complementing these observations with a laser Doppler flowmetry (LDF investigation of the microcirculation state and an evaluation of the plasma oxidative status. After four months of treatment, a statistically significant higher, and dose-dependent, improvement in all endpoints was observed in the treatment groups compared to that of the control, with blood pressure normalizing in 93% of the higher dosage (300 mg treatment group. Taken together, these observations suggest that GSPEs have beneficial cardiovascular effects that complement current intervention strategies in the hypertension area. The effect on blood pressure adds to the beneficial effects of GSPEs on the cardiovascular disease (CVD phenotype associated with the oxidation of membrane lipids (endothelial dysfunction, formation of oxidized LDL, and activation of phagocytic cells.

  17. Prevalence, awareness, medication, control, and risk factors associated with hypertension in Yi ethnic group aged 50 years and over in rural China: the Yunnan minority eye study.

    Chen, Lixing; Zong, Yuan; Wei, Tao; Sheng, Xun; Shen, Wei; Li, Jun; Niu, Zhiqiang; Zhou, Hua; Zhang, Yang; Yuan, Yuansheng; Chen, Qin; Zhong, Hua

    2015-04-15

    Hypertension is an important public health issue in China, but there are few studies examining hypertension in ethnic groups in Yunnan, China. This study, Yunnan Minority Eye Study (YMES), was initially designed to determine the prevalence and impact of eye diseases, including hypertension and diabetes mellitus. As a part of YMES, the prevalence, awareness, treatment, and control of hypertension and the associated risk factors among the Yi ethnic population in rural China are reported. A population-based survey was conducted in 2012 with adult participants over 50 from rural communities in Shilin Yi Autonomous County, Yunnan Province, located in southwest China. A random cluster sampling method was used to select a representative sample. The participants' blood pressure, height, weight, and waist circumference were measured. Hypertension was defined as mean systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg, and/or current use of antihypertensive medications. A total of 2208 adults were assessed. The prevalence of hypertension was 38.5%, and the age- and gender-adjusted prevalence was 37.0%. The proportion of patients who were aware of their hypertension among those diagnosed with hypertension was 24.8%. Of those aware of having hypertension, 23.6% took antihypertensive drugs. Among all hypertensive patients, only 7.2% had controlled their hypertension (population of the Yi ethnic group in China. The ratio of awareness, treatment, and control of hypertension were considerately low. Hypertension education and screening programs in rural China are recommended to improve the health status of this population.

  18. DRUG UTILISATION STUDY IN THE TREATMENT OF HYPERTENSION IN A TERTIARY CARE HOSPITAL

    Amol Chandrakant Deshmukh

    2017-11-01

    Full Text Available BACKGROUND Hypertension, a common clinical problem is considered as an ‘iceberg disease’ because its unknown morbidity far exceeds the known morbidity. In terms of attributable deaths, it is one of the leading behavioural and physiological risk factors amounting to 13% of global deaths. Drug selection is based on efficacy in lowering BP (blood pressure and in reducing Cardiovascular (CV endpoints like stroke, myocardial infarction and heart failure. This study was carried out to evaluate the pattern, extent, rationality and frequency of the use of antihypertensive drugs in the treatment of hypertension. The aim of the study is to analyse drug utilisation in the treatment of hypertension in a tertiary care hospital. MATERIALS AND METHODS This study was conducted during January 2014 to December 2015 in Medicine OPD (Outpatient Department in a tertiary care hospital. The sample size was selected as per the WHO recommendations on conducting Drug Utilisation Studies (DUS. Statistical Analysis- The collected data was numerically coded and entered in Microsoft Excel 2007 and analysed by SPSS version 16. Settings and Design- Prospective, cross-sectional, observational study. RESULTS Out of 612 patients, 262 (42.81% were in the age group of 60 and above. Considering gender distribution, 328 (53.59% were males and 284 (46.41% were females. Of these, 274 (44.78% were prescribed monotherapy, 256 (41.83% were prescribed two-drug therapy, 72 (11.76% were prescribed three-drug therapy and 10 (1.63% were prescribed four-drug therapy. Among 274 (44.78% patients prescribed with monotherapy, 112 (40.87% were prescribed with CCB (calcium channel blocker, 76 (27.73% were given BB (B-blocker, 45 (16.42% were prescribed ACEI (angiotensin converting enzyme inhibitor, 35 (12.77% were prescribed with ARB (angiotensin receptor blocker and 6 (2.18% were prescribed with Diuretics (D. Of the total antihypertensive drugs prescribed, 68.30% were prescribed by generic name

  19. Knowledge and awareness of hypertension among patients with systemic hypertension.

    Familoni, B. Oluranti; Ogun, S. Abayomi; Aina, A. Olutoyin

    2004-01-01

    BACKGROUND: In Nigeria, systemic hypertension is the commonest noncommunicable disease, and public awareness about hypertension and its determinants is poor. This study aims to assess the knowledge and level of awareness of the disease among hypertensive patients attending the medical outpatient clinic of Olabisi Onabanjo University Teaching Hospital (OOUTH). METHODOLOGY: Hypertensive patients who attended the medical outpatient clinic during the one-year study period and gave their consent were recruited into the study. Response to a questionnaire on various aspects of hypertension was analyzed using the STATA for Windows software. RESULTS: There were 254 hypertensive patients, of which 111 were males and 143 were females, giving a male: female ratio of 1:1.3. The mean age (SD) of the patients was 51 years +/- 12.2; 52.4% of the participants were aware that hypertension was the commonest noncommunicable disease in Nigeria. About one in 10 patients (11.4%) was aware that "nil symptom" is the commonest symptom of hypertension, while 37% were not aware that hypertension could cause renal failure. Only about one-third (35.4%) of the patients knew that hypertension should ideally be treated for life, while 58.3% believed that antihypertensive drugs should be used only when there are symptoms. The remaining 6.3% believed that the treatment of hypertension should be for periods ranging from two weeks to five years but not for life. CONCLUSION: This study has demonstrated inadequate knowledge of hypertension in patients with hypertension in our study population. Conscious efforts should be made and time set aside to health educate hypertensive patients. Organization of "hypertensive club or society" could be encouraged. These will reduce dissemination of false or inaccurate information by hypertensive patients to the public and its attendant dangers. PMID:15160976

  20. Effects of psychological stress on hypertension in middle-aged Chinese: a cross-sectional study.

    Bo Hu

    Full Text Available We examined the effect and relative contributions of different types of stress on the risk of hypertension. Using cluster sampling, 5,976 community-dwelling individuals aged 40-60 were selected. Hypertension was defined according to the Seventh Report of the Joint National Committee, and general psychological stress was defined as experiencing stress at work or home. Information on known risk factors of hypertension (e.g., physical activity levels, food intake, smoking behavior was collected from participants. Logistic regression analysis was used to determine the associations between psychological stress and hypertension, calculating population-attributable risks and 95% confidence intervals (CIs. General stress was significantly related to hypertension (odds ratio [OR] = 1.247, 95% CI [1.076, 1.446]. Additionally, after adjustment for all other risk factors, women showed a greater risk of hypertension if they had either stress at work or at home: OR = 1.285, 95% CI (1.027, 1.609 and OR = 1.231, 95% CI (1.001, 1.514, respectively. However, this increased risk for hypertension by stress was not found in men. General stress contributed approximately 9.1% (95% CI [3.1, 15.0] to the risk for hypertension. Thus, psychological stress was associated with an increased risk for hypertension, although this increased risk was not consistent across gender.

  1. A poor performance in comprehensive geriatric assessment is associated with increased fall risk in elders with hypertension: a cross-sectional study

    Chu, Jiao-Jiao; Chen, Xu-Jiao; Shen, Shan-Shan; Zhang, Xue-Feng; Chen, Ling-Yan; Zhang, Jing-Mei; He, Jing; Zhao, Jun-Feng

    2015-01-01

    Background Fall and serious fall injuries have become a major health concern for elders. Many factors including blood pressure and anti-hypertensive medication application were reported as hazards of fall. The purpose of this study was to determine if age related systemic functional decline related with increased fall risks in elderly patients with hypertension. Methods A total of 342 elderly hypertension patients (age 79.5 ? 6.7 years, male 63.8%) were recruited to the study. Comprehensive g...

  2. Weight status and hypertension among adolescent girls in Argentina and Norway: Data from the ENNyS and HUNT studies

    Vik Torstein

    2009-10-01

    Full Text Available Abstract Background To provide data on overweight, obesity and hypertension among adolescent girls in Norway and Argentina. Methods Data was obtained from two population-based, cross-sectional and descriptive studies containing anthropometric and blood pressure measurements of 15 to 18 year old girls. The study included 2,156 adolescent girls from Norway evaluated between 1995 and 1997, and 669 from Argentina evaluated between 2004 and 2005. Results Around 15% of adolescent girls in Norway and 19% in Argentina are overweight or obese. Body mass index (BMI distribution in these two countries is similar, with a low percentage (th - 90th percentile were associated with hypertension. Conclusion This study confirms a current world health problem by showing the high prevalence of obesity in adolescents and its association with hypertension in two different countries (one developed and one in transition.

  3. Medical expenditures of men with hypertension and/or a smoking habit: a 10-year follow-up study of National Health Insurance in Shiga, Japan.

    Nakamura, Koshi; Okamura, Tomonori; Hayakawa, Takehito; Kanda, Hideyuki; Okayama, Akira; Ueshima, Hirotsugu

    2010-08-01

    Hypertension and smoking are major causes of disability and death, especially in the Asia-Pacific region, where there is a high prevalence of a combination of these two risk factors. We attempted to measure the medical expenditures of a Japanese male population with hypertension and/or a smoking habit over a 10-year period of follow-up. A cohort study was conducted that investigated the medical expenditures due to a smoking habit and/or hypertension during the decade of the 1990s using existing data on physical status and medical expenditures. The participants included 1708 community-dwelling Japanese men, aged 40-69 years, who were classified into the following four categories: 'neither smoking habit nor hypertension', 'smoking habit alone', 'hypertension alone' or 'both smoking habit and hypertension.' Hypertension was defined as a systolic blood pressure of > or =140 mm Hg, a diastolic blood pressure of > or =90 mm Hg or taking antihypertensive medications. In the study cohort, 24.9% had both a smoking habit and hypertension. During the 10-year follow-up period, participants with a smoking habit alone (18,444 Japanese yen per month), those with hypertension alone (21,252 yen per month) and those with both a smoking habit and hypertension (31,037 yen per month) had increased personal medical expenditures compared with those without a smoking habit and hypertension (17,418 yen per month). Similar differences were observed even after adjustment for other confounding factors (Psmoking habit and hypertension incurred higher medical expenditures compared with those without a smoking habit, hypertension or their combination.

  4. Associations between thoracic radiographic changes and severity of pulmonary arterial hypertension diagnosed in 60 dogs via Doppler echocardiography: A retrospective study.

    Adams, Dustin S; Marolf, Angela J; Valdés-Martínez, Alejandro; Randall, Elissa K; Bachand, Annette M

    2017-07-01

    Doppler echocardiography is a noninvasive method for estimating and grading pulmonary arterial hypertension. No current literature associates significance of radiographic findings with severity of pulmonary arterial hypertension. We hypothesized that the number and conspicuity of radiographic findings suggestive of pulmonary arterial hypertension would be greater based on the severity of pulmonary arterial hypertension. Dogs with pulmonary arterial hypertension and normal control dogs were included in this retrospective, case control study. Three radiologists blinded to echocardiographic results scored thoracic radiographs for right ventricular and main pulmonary artery enlargement and pulmonary lobar artery enlargement, tortuosity, and blunting by multiple methods. Presence or absence of each finding was scored in an additive fashion and averaged for each grade of pulmonary arterial hypertension severity. Seventy-one dogs (60 dogs with pulmonary arterial hypertension and 11 control dogs) of which some had multiple studies were included: 20 mild, 21 moderate, 25 severe, and 11 absent pulmonary arterial hypertension. The following radiographic findings were significantly associated with increasing pulmonary arterial hypertension severity: right ventricular enlargement by "reverse D" and "3/5-2/5 cardiac ratio" methods, main pulmonary artery enlargement, and caudal lobar artery enlargement by the "3rd rib" method. Mean scores for severe pulmonary arterial hypertension and normal dogs were significantly different (P-value < 0.0001). Mean scores between different pulmonary arterial hypertension grades increased with severity but were not statistically significant. Individually and in combination, radiographic findings performed poorly in differentiating severity of pulmonary arterial hypertension. Findings indicated that thoracic radiographs should be utilized in conjunction with Doppler echocardiography in a complete diagnostic work-up for dogs with suspected

  5. Prevalence of histological features of idiopathic noncirrhotic portal hypertension in general population: a retrospective study of incidental liver biopsies.

    Zuo, Chunlai; Chumbalkar, Vaibhav; Ells, Peter F; Bonville, Daniel J; Lee, Hwajeong

    2017-09-01

    Idiopathic noncirrhotic portal hypertension (INCPH) is associated with histologic changes secondary to obliterative portal venopathy without cirrhosis. We studied the prevalence of individual histological features of INCPH in liver biopsies obtained incidentally during unrelated elective procedures and in elective liver biopsies with the diagnosis of fatty liver disease. A total of 53 incidental liver biopsies obtained intraoperatively during unrelated elective procedures and an additional 28 elective biopsies with the diagnosis of fatty liver disease without portal hypertension and cirrhosis were studied. Various histologic features of INCPH were evaluated. Shunt vessel (30%), phlebosclerosis (27%), increased number of portal vessels (19%) and incomplete septa (17%) were common in these liver biopsies after confounding factors such as co-existing fatty liver disease or fibrosis were excluded. At least one feature of INCPH was noted in 90% of the biopsies. Eight (10%) biopsies showed 5-6 features of INCPH. In total, 11 (14%) of 81 patients had risk factors associated with INCPH, including hypercoagulability, autoimmune disease, exposure to drugs, and infections. No patient had portal hypertension at the end of the follow-up. The histologic features of INCPH are seen in incidental liver biopsies and fatty liver disease without portal hypertension. Ten percent of the biopsies show 5-6 features of INCPH without portal hypertension. Interpreting histologic features in the right clinical context is important for proper patient care.

  6. The interaction effect of effort-reward imbalance and overcommitment on hypertension among Chinese workers: findings from SHISO study.

    Xu, Weixian; Yu, Haiyi; Hang, Juan; Gao, Wei; Zhao, Yiming; Guo, Lijun

    2013-12-01

    No previous studies investigated the interaction of effort-reward imbalance (ERI) and overcommitment on blood pressure. Our aim was to investigate associations of ERI and overcommitment (and their interaction) with blood pressure and hypertension within a Chinese population. Seven hundred thirty-four participants from the Stress and Health in Shenzhen Workers study completed a demographics, job stressor and risk factor questionnaire, and their blood pressure was measured by mercury sphygmomanometers. Risk factors for blood pressure were analyzed by multiple linear regression and risk factors for hypertension by Poisson regression. Overcommitment was associated with diastolic blood pressure after adjustment for confounders and ERI among men (β = 0.17, P controlling for overcommitment, ERI remained significantly associated with hypertension risk (PR = 2.38, 95% CI 1.53-3.71). When high overcommitment and high ERI was combined, hypertension risk was highest (adjusted PR = 2.99, 95% CI 1.82-4.91, adjusted synergy index 5.85). The interaction was significant when it was tested by an interaction term in the regression (P < 0.001). The interaction effect of overcommitment and ERI on hypertension was independent and synergistic. © 2013 Wiley Periodicals, Inc.

  7. Effects of prediabetes mellitus alone or plus hypertension on subsequent occurrence of cardiovascular disease and diabetes mellitus: longitudinal study.

    Qiu, Miaoyan; Shen, Weili; Song, Xiaomin; Ju, Liping; Tong, Wenxin; Wang, Haiyan; Zheng, Sheng; Jin, Yan; Wu, Yixin; Wang, Weiqing; Tian, Jingyan

    2015-03-01

    Whether prediabetes mellitus alone or combined with other disorders means a higher risk for cardiovascular disease (CVD) is still controversial. This study aimed to investigate the association between prediabetes mellitus and CVD and diabetes mellitus and to explore whether prediabetes mellitus alone or combined with other syndromes, such as hypertension, could promote CVD risks significantly. This longitudinal population-based study of 1609 residents from Shanghai in Southern China was conducted between 2002 and 2014. Participants with a history of CVD at baseline were excluded from analysis. Multivariate log-binomial regression models were used to adjust possible coexisting factors. Incidence of CVD during follow-up was 10.1%. After adjusting for age, sex, and other factors, the association between prediabetes mellitus and CVD was not observed. When hypertension was incorporated in stratifying factors, adjusted CVD risk was elevated significantly (odds ratio, 2.41; 95% confidence interval, 1.25-4.64) in prediabetes mellitus and hypertension combined group, and coexistence of diabetes mellitus and hypertension made CVD risk highly significantly increased, reaching 3.43-fold higher than the reference group. Blood glucose level within prediabetic range is significantly associated with elevated risks for diabetes mellitus after multivariable adjustment, but only when it is concurrent with other disorders, such as hypertension, it will significantly increase CVD risk. © 2015 American Heart Association, Inc.

  8. Cross-sectional association between perceived discrimination and hypertension in African-American men and women: the Pitt County Study.

    Roberts, Calpurnyia B; Vines, Anissa I; Kaufman, Jay S; James, Sherman A

    2008-03-01

    Few studies have examined the impact of the frequency of discrimination on hypertension risk. The authors assessed the cross-sectional associations between frequency of perceived racial and nonracial discrimination and hypertension among 1,110 middle-aged African-American men (n = 393) and women (n = 717) participating in the 2001 follow-up of the Pitt County Study (Pitt County, North Carolina). Odds ratios were estimated using gender-specific unconditional weighted logistic regression with adjustment for relevant confounders and the frequency of discrimination. More than half of the men (57%) and women (55%) were hypertensive. The prevalences of perceived racial discrimination, nonracial discrimination, and no discrimination were 57%, 29%, and 13%, respectively, in men and 42%, 43%, and 15%, respectively, in women. Women recounting frequent nonracial discrimination versus those reporting no exposure to discrimination had the highest odds of hypertension (adjusted odds ratio = 2.34, 95% confidence interval: 1.09, 5.02). A nonsignificant inverse odds ratio was evident in men who perceived frequent exposure to racial or nonracial discrimination in comparison with no exposure. A similar association was observed for women reporting perceived racial discrimination. These results indicate that the type and frequency of discrimination perceived by African-American men and women may differentially affect their risk of hypertension.

  9. Hypertension in postmenopausal women: how to approach hypertension in menopause.

    Modena, Maria Grazia

    2014-09-01

    During fertile life women are usually normo or hypotensive. Hypertension may appear during pregnancy and this represents a peculiar phenomenon increasing nowadays for delay time of pregnancy. Gestational hypertension appears partially similar to hypertension in the context of metabolic syndrome for a similar condition of increased waste circumference. Parity, for the same pathogenesis, has been reported to be associated to peri and postmenopausal hypertension, not confirmed by our study of parous women with transitional non persistent perimenopausal hypertension. Estrogen's deficiency inducing endothelial dysfunction and increased body mass index are the main cause for hypertension in this phase of life. For these reasons lifestyle modification, diet and endothelial active drugs represent the ideal treatment. Antioxidant agents may have a role in prevention and treatment of hypertension. In conclusion, hypertension in women represents a peculiar constellation of different biological and pathogenic factors, which need a specific gender related approach, independent from the male model.

  10. Measuring medication adherence in patients with incident hypertension: a retrospective cohort study.

    Tang, Karen L; Quan, Hude; Rabi, Doreen M

    2017-02-13

    Though pharmacy claims data are commonly used to study medication adherence, there remains no standard operational definition for adherence especially for patients on multiple medications. Even when studies use the same terminology, the actual methods of calculating adherence can differ drastically. It is unclear whether the use of different definitions results in different conclusions regarding adherence and associated outcomes. The objective of our study was to compare adherence rates and associations with mortality using different operational definitions of adherence, and using various methods of handling concurrent medication use. We conducted a cohort study of patients aged ≥65 years from Manitoba, Canada, with incident hypertension diagnosed in 2004 and followed to 2009. We calculated adherence rates to anti-hypertensive medications using different operational definitions of medication adherence (including interval and prescription based medication possession ratios [MPR] and proportion of days covered [PDC]). For those on concurrent medications, we calculated adherence rates using the different methods of handling concurrent medication use, for each definition. We used logistic regression to determine the association between adherence and mortality for each operational definition. Among 2199 patients, 24.1% to 90.5% and 71.2% to 92.7% were considered adherent when using fixed interval and prescription-based interval medication possession ratios [MPRi and MPRp] respectively, depending on how concurrent medications were handled. Adherence was inversely associated with death, with the strongest association for MPRp measures. This association was significant only when considering adherence to any anti-hypertensive [aOR 0.70, 95% CI 0.51, 0.97], or when the mean of the class-specific MPRp's [adjusted OR 0.71, 95% CI 0.53, 0.95] was used. No significant association existed when the highest or lowest class-specific MPRp was used as the adherence estimate. The

  11. A Concept Mapping Study of Physicians’ Perceptions of Factors Influencing Management and Control of Hypertension in Sub-Saharan Africa

    Juliet Iwelunmor

    2015-01-01

    Full Text Available Hypertension, once a rare problem in Sub-Saharan Africa (SSA, is predicted to be a major cause of death by 2020 with mortality rates as high as 75%. However, comprehensive knowledge of provider-level factors that influence optimal management is limited. The objective of the current study was to discover physicians’ perceptions of factors influencing optimal management and control of hypertension in SSA. Twelve physicians attending the Cardiovascular Research Training (CaRT Institute at the University of Ghana, College of Health Sciences, were invited to complete a concept mapping process that included brainstorming the factors influencing optimal management and control of hypertension in patients, sorting and organizing the factors into similar domains, and rating the importance and feasibility of efforts to address these factors. The highest ranked important and feasible factors include helping patients accept their condition and availability of adequate equipment to enable the provision of needed care. The findings suggest that patient self-efficacy and support, physician-related factors, policy factors, and economic factors are important aspects that must be addressed to achieve optimal hypertension management. Given the work demands identified by physicians, future research should investigate cost-effective strategies of shifting physician responsibilities to well-trained no-physician clinicians in order to improve hypertension management.

  12. High-frequency hearing loss, occupational noise exposure and hypertension: a cross-sectional study in male workers.

    Chang, Ta-Yuan; Liu, Chiu-Shong; Huang, Kuei-Hung; Chen, Ren-Yin; Lai, Jim-Shoung; Bao, Bo-Ying

    2011-04-25

    The association between occupational noise exposure and hypertension is inconsistent because of an exposure bias caused by outer-ear measurements of noise levels among workers. This study used hearing loss values (HLVs) measured at 4 kHz and 6 kHz in both ears as a biomarker to investigate the chronic effects of noise exposure on hypertension in 790 aircraft-manufacturing workers. Participants were divided into a high hearing loss (HL) group (n = 214; average HLVs ≥ 30 decibel [dB] at 4 kHz or 6 kHz bilaterally; 83.1 ± 4.9 A-weighted decibel [dBA]), a median HL group (n = 302; 15 ≤ average HLVs workers had 1.48-fold (95% confidence interval [95%CI] = 1.02-2.15; p = 0.040) and 1.46-fold (95%CI = 1.03-2.05; p = 0.031) higher risks of hypertension relative to the low HL workers. Employment duration was significantly and positively correlated with the risk of hypertension among workers with average HLVs ≥ 15 dB at 4 kHz (p hearing loss is a good biomarker of occupational noise exposure and that noise-induced hearing loss may be associated with the risk of hypertension.

  13. Resistant Hypertension.

    Doroszko, Adrian; Janus, Agnieszka; Szahidewicz-Krupska, Ewa; Mazur, Grzegorz; Derkacz, Arkadiusz

    2016-01-01

    Resistant hypertension is a severe medical condition which is estimated to appear in 9-18% of hypertensive patients. Due to higher cardiovascular risk, this disorder requires special diagnosis and treatment. The heterogeneous etiology, risk factors and comorbidities of resistant hypertension stand in need of sophisticated evaluation to confirm the diagnosis and select the best therapeutic options, which should consider lifestyle modifications as well as pharmacological and interventional treatment. After having excluded pseudohypertension, inappropriate blood pressure measurement and control as well as the white coat effect, suspicion of resistant hypertension requires an analysis of drugs which the hypertensive patient is treated with. According to one definition - ineffective treatment with 3 or more antihypertensive drugs including diuretics makes it possible to diagnose resistant hypertension. A multidrug therapy including angiotensin - converting enzyme inhibitors, angiotensin II receptor blockers, beta blockers, diuretics, long-acting calcium channel blockers and mineralocorticoid receptor antagonists has been demonstrated to be effective in resistant hypertension treatment. Nevertheless, optional, innovative therapies, e.g. a renal denervation or baroreflex activation, may create a novel pathway of blood pressure lowering procedures. The right diagnosis of this disease needs to eliminate the secondary causes of resistant hypertension e.g. obstructive sleep apnea, atherosclerosis and renal or hormonal disorders. This paper briefly summarizes the identification of the causes of resistant hypertension and therapeutic strategies, which may contribute to the proper diagnosis and an improvement of the long term management of resistant hypertension.

  14. MRI in patients with portal hypertension (preoperative and postoperative studies). The first 15 cases

    Pozzato, A; Cattoni, F; Baldini, U and others

    1987-01-01

    Fifteen patients with portal hypertension were examined by magnetic resonance imaging (MRI) using spin-echo sequences. Sagittal and transaxial images were obtained in all cases. Ten subjects have been evaluated after portosystemic shunt operations (6 portocaval and 4 splenorenal shunts); 5 patients were studied by MRI before shunt placements. Angiographic correlation was obtained in 15 cases. In each of the preoperative examinations, MRI accurately depicted inferior vena cava, portal vein and splenic vein. Shunt patency was documented in 10/10 postoperative studies: portacaval shunts patency was better determined in the transaxial plane while splenorenal shunts were better demonstrted in the sagittal plane. Thus, MRI seems to be an accurate and noninvasive method for detecting portosystemic shunt patency without the use of intravenous contrast media and without patient exposure to radiation.

  15. Interactions of Genes and Sodium Intake on the Development of Hypertension: A Cohort-Based Case-Control Study

    Mei-Ling Chen

    2018-05-01

    Full Text Available There have been few studies investigating interactions of G-protein beta3 subunit (GNB3 C825T (rs5443 and dietary sodium intake on the risk of hypertension, i.e., BP salt sensitivity. The study aims to evaluate joint effects of GNB3 polymorphisms and sodium consumption on the development of hypertension. A cohort-based case-control study was conducted in 2014. There are 233 participants with newly diagnosed hypertension in the case group and 699 participants in the gender-matched control group. The primary outcome is the development of hypertension over a 10-year period. The determinants of hypertension were three genotypes of SNP in GNB3 (TT; CT; and CC and two dietary salt categories on the basis of the level of sodium consumption representing high (>4800 mg/day and low-sodium (<2400 mg/day diets. The development of hypertension increased with participants carrying TT genotype and high-sodium diets comparing with those carrying TC or CC genotype with low-sodium diets (adjusted OR 3.23, 95% CI 1.52–6.83 (Rothman synergy index = 3.79. The study suggests that GNB3 C825T polymorphism may influence the response of the renin-angiotensin system to high-sodium diet. It implies that GNB3 can be served as an easy, inexpensive, and early genetic marker of salt sensitivity to blood pressure. Salt-sensitive individuals should pay more attention to salt intake to reduce cardiovascular morbidity or mortality.

  16. Genome-wide association study of young-onset hypertension in the Han Chinese population of Taiwan.

    Hsin-Chou Yang

    Full Text Available Young-onset hypertension has a stronger genetic component than late-onset counterpart; thus, the identification of genes related to its susceptibility is a critical issue for the prevention and management of this disease. We carried out a two-stage association scan to map young-onset hypertension susceptibility genes. The first-stage analysis, a genome-wide association study, analyzed 175 matched case-control pairs; the second-stage analysis, a confirmatory association study, verified the results at the first stage based on a total of 1,008 patients and 1,008 controls. Single-locus association tests, multilocus association tests and pair-wise gene-gene interaction tests were performed to identify young-onset hypertension susceptibility genes. After considering stringent adjustments of multiple testing, gene annotation and single-nucleotide polymorphism (SNP quality, four SNPs from two SNP triplets with strong association signals (-log(10(p>7 and 13 SNPs from 8 interactive SNP pairs with strong interactive signals (-log(10(p>8 were carefully re-examined. The confirmatory study verified the association for a SNP quartet 219 kb and 495 kb downstream of LOC344371 (a hypothetical gene and RASGRP3 on chromosome 2p22.3, respectively. The latter has been implicated in the abnormal vascular responsiveness to endothelin-1 and angiotensin II in diabetic-hypertensive rats. Intrinsic synergy involving IMPG1 on chromosome 6q14.2-q15 was also verified. IMPG1 encodes interphotoreceptor matrix proteoglycan 1 which has cation binding capacity. The genes are novel hypertension targets identified in this first genome-wide hypertension association study of the Han Chinese population.

  17. A randomized controlled trial of community health workers using patient stories to support hypertension management: Study protocol.

    Hargraves, J Lee; Bonollo, Debra; Person, Sharina D; Ferguson, Warren J

    2018-04-12

    Uncontrolled hypertension is a significant public health problem in the U.S. with about one half of people able to keep blood pressure (BP) under control. Uncontrolled hypertension leads to increased risk of stroke, heart attack, and death. Furthermore, the social and economic costs of poor hypertension control are staggering. People living with hypertension can benefit from additional educational outreach and support. This randomized trial conducted at two Community Health Centers (CHCs) in Massachusetts assessed the effect of community health workers (CHWs) assisting patients with hypertension. In addition to the support provided by CHWs, the study uses video narratives from patients who have worked to control their BP through diet, exercise, and better medication adherence. Participants enrolled in the study were randomly assigned to immediate intervention (I) by CHWs or a delayed intervention (DI) (4 to 6 months later). Each participant was asked to meet with the CHW 5 times (twice in person and three times telephonically). Study outcomes include systolic and diastolic BP, diet, exercise, and body mass index. CHWs working directly with patients, using multiple approaches to support patient self-management, can be effective agents to support change in chronic illness management. Moreover, having culturally appropriate tools, such as narratives available through videos, can be an important, cost effective aid to CHWs. Recruitment and intervention delivery within a busy CHC environment required adaptation of the study design and protocols for staff supervision, data collection and intervention delivery and lessons learned are presented. Clinical Trials.gov registration submitted 8/17/16: Protocol ID# 5P60MD006912-02 and Clinical trials.gov ID# NCT02874547 Community Health Workers Using Patient Stories to Support Hypertension Management. Copyright © 2018. Published by Elsevier Inc.

  18. Neighborhood perceptions and hypertension among low-income black women: a qualitative study

    Maliyhah Al-Bayan

    2016-10-01

    Full Text Available Abstract Background The majority of studies examining the role of neighborhoods and hypertension-related outcomes have been quantitative in nature and very few studies have examined specific disadvantaged populations, including low-income housing residents. The objective of this study was to use qualitative interviews to explore low-income Black women’s perceptions of their neighborhoods and to understand how those perceptions may affect their health, especially as it relates to blood pressure. Methods Seventeen Black female participants, living in public housing communities in New York City, completed one semi-structured, audiotaped interview in July of 2014. All interviews were transcribed, coded, and analyzed for emerging themes using N’Vivo 10 software. Results Three major themes emerged: (1 social connectedness, (2 stress factors, and (3 availability of food options. For example, factors that caused stress varied throughout the study population. Sources of stress included family members, employment, and uncleanliness within the neighborhood. Many participants attributed their stress to personal issues, such as lack of employment and relationships. In addition, the general consensus among many participants was that there should be a greater density of healthy food options in their neighborhoods. Some believed that the pricing of fresh foods in the neighborhoods should better reflect the financial status of the residents in the community. Conclusions Various neighborhood influences, including neighborhood disorder and lack of healthy food options, are factors that appear to increase Black women’s risk of developing high blood pressure. Implications of this research include the need to develop interventions that promote good neighborhood infrastructure (e.g. healthy food stores to encourage good nutrition habits and well-lit walking paths to encourage daily exercise, in addition to interventions that increase hypertension awareness in

  19. A cross-sectional study of hypertensive outpatients to determine the ...

    Background: Erectile dysfunction (ED) is common amongst hypertensive men. Hypertensive patients often attribute it to antihypertensive drugs, although conflicting evidence linking ED with antihypertensive medication exists. The objectives were to determine the prevalence and severity of ED, the type of treatment sought, ...

  20. Surgical Treatment of Cervical Spondylotic Myelopathy Associated Hypertension--A Retrospective Study of 309 Patients.

    Ze-qun Li

    Full Text Available Hypertension is the most prevalent cardiovascular disease, and various risk factors are known to be involved in it. Cervical spondylotic myelopathy (CSM is the most common non-traumatic cause of myelopathy, which displays neurological symptoms and may induce systemic symptoms. To date, it is still unknown whether CSM is associated with hypertension, and if so, whether the decompression operations can attenuate CSM associated hypertension. Here, a total of 309 patients with CSM who received anterior or posterior decompression surgery were enrolled as subjects. Blood pressure measurements were performed before and within one week after the surgery. Among the 309 subjects, 144 (46.6% of them exhibited hypertension before surgery, a significantly higher ratio than that of the whole population. One week after surgery, blood pressure of 106 (73.6% patients turned back to normal. Blood pressure of another 37(25.7% patients decreased with different degrees, although still higher than normal. Moreover, it appears that both approaches were effective in improving blood pressure, while the posterior approach was more effective in decreasing systolic blood pressure. We speculate this type of hypertension might result from hyperactivity of sympathetic nervous system as the heart rate of these patients decreased after surgery as well. Collectively, compression of spinal cord in CSM patients might be associated with hypertension, and decompression surgery largely attenuated this type of hypertension. These findings prove CSM to be a potential associated factor of high blood pressure and may shed light on therapies of hypertension in clinics.

  1. Association of General and Abdominal Obesity With Hypertension, Dyslipidemia and Prediabetes in the PREDAPS Study.

    Sangrós, F Javier; Torrecilla, Jesús; Giráldez-García, Carolina; Carrillo, Lourdes; Mancera, José; Mur, Teresa; Franch, Josep; Díez, Javier; Goday, Albert; Serrano, Rosario; García-Soidán, F Javier; Cuatrecasas, Gabriel; Igual, Dimas; Moreno, Ana; Millaruelo, J Manuel; Carramiñana, Francisco; Ruiz, Manuel Antonio; Pérez, Francisco Carlos; Iriarte, Yon; Lorenzo, Ángela; González, María; Álvarez, Beatriz; Barutell, Lourdes; Mayayo, M Soledad; Del Castillo, Mercedes; Navarro, Emma; Malo, Fernando; Cambra, Ainhoa; López, Riánsares; Gutiérrez, M Ángel; Gutiérrez, Luisa; Boente, Carmen; Mediavilla, J Javier; Prieto, Luis; Mendo, Luis; Mansilla, M José; Ortega, Francisco Javier; Borras, Antonia; Sánchez, L Gabriel; Obaya, J Carlos; Alonso, Margarita; García, Francisco; Gutiérrez, Ángela Trinidad; Hernández, Ana M; Suárez, Dulce; Álvarez, J Carlos; Sáenz, Isabel; Martínez, F Javier; Casorrán, Ana; Ripoll, Jazmín; Salanova, Alejandro; Marín, M Teresa; Gutiérrez, Félix; Innerárity, Jaime; Álvarez, M Del Mar; Artola, Sara; Bedoya, M Jesús; Poveda, Santiago; Álvarez, Fernando; Brito, M Jesús; Iglesias, Rosario; Paniagua, Francisca; Nogales, Pedro; Gómez, Ángel; Rubio, José Félix; Durán, M Carmen; Sagredo, Julio; Gijón, M Teresa; Rollán, M Ángeles; Pérez, Pedro P; Gamarra, Javier; Carbonell, Francisco; García-Giralda, Luis; Antón, J Joaquín; de la Flor, Manuel; Martínez, Rosario; Pardo, José Luis; Ruiz, Antonio; Plana, Raquel; Macía, Ramón; Villaró, Mercè; Babace, Carmen; Torres, José Luis; Blanco, Concepción; Jurado, Ángeles; Martín, José Luis; Navarro, Jorge; Sanz, Gloria; Colas, Rafael; Cordero, Blanca; de Castro, Cristina; Ibáñez, Mercedes; Monzón, Alicia; Porta, Nuria; Gómez, María Del Carmen; Llanes, Rafael; Rodríguez, J José; Granero, Esteban; Sánchez, Manuel; Martínez, Juan; Ezkurra, Patxi; Ávila, Luis; de la Sen, Carlos; Rodríguez, Antonio; Buil, Pilar; Gabriel, Paula; Roura, Pilar; Tarragó, Eduard; Mundet, Xavier; Bosch, Remei; González, J Carles; Bobé, M Isabel; Mata, Manel; Ruiz, Irene; López, Flora; Birules, Marti; Armengol, Oriol; de Miguel, Rosa Mar; Romera, Laura; Benito, Belén; Piulats, Neus; Bilbeny, Beatriz; Cabré, J José; Cos, Xavier; Pujol, Ramón; Seguí, Mateu; Losada, Carmen; de Santiago, A María; Muñoz, Pedro; Regidor, Enrique

    2018-03-01

    Some anthropometric measurements show a greater capacity than others to identify the presence of cardiovascular risk factors. This study estimated the magnitude of the association of different anthropometric indicators of obesity with hypertension, dyslipidemia, and prediabetes (altered fasting plasma glucose and/or glycosylated hemoglobin). Cross-sectional analysis of information collected from 2022 participants in the PREDAPS study (baseline phase). General obesity was defined as body mass index ≥ 30kg/m 2 and abdominal obesity was defined with 2 criteria: a) waist circumference (WC) ≥ 102cm in men/WC ≥ 88cm in women, and b) waist-height ratio (WHtR) ≥ 0.55. The magnitude of the association was estimated by logistic regression. Hypertension showed the strongest association with general obesity in women (OR, 3.01; 95%CI, 2.24-4.04) and with abdominal obesity based on the WHtR criterion in men (OR, 3.65; 95%CI, 2.66-5.01). Hypertriglyceridemia and low levels of high-density lipoprotein cholesterol showed the strongest association with abdominal obesity based on the WHtR criterion in women (OR, 2.49; 95%CI, 1.68-3.67 and OR, 2.70; 95%CI, 1.89-3.86) and with general obesity in men (OR, 2.06; 95%CI, 1.56-2.73 and OR, 1.68; 95%CI, 1.21-2.33). Prediabetes showed the strongest association with abdominal obesity based on the WHtR criterion in women (OR, 2.48; 95%CI, 1.85-3.33) and with abdominal obesity based on the WC criterion in men (OR, 2.33; 95%CI, 1.75-3.08). Abdominal obesity indicators showed the strongest association with the presence of prediabetes. The association of anthropometric indicators with hypertension and dyslipidemia showed heterogeneous results. Copyright © 2017 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  2. Inter-practice variation in diagnosing hypertension and diabetes mellitus: a cross-sectional study in general practice

    Nielen, M.M.J.; Schellevis, F.G.; Verheij, R.A.

    2009-01-01

    BACKGROUND: Previous studies of inter-practice variation of the prevalence of hypertension and diabetes mellitus showed wide variations between practices. However, in these studies inter-practice variation was calculated without controlling for clustering of patients within practices and without

  3. Inter-practice variation in diagnosing hypertension and diabetes mellitus: a cross-sectional study in general practice.

    Nielen, M.M.J.; Schellevis, F.G.; Verheij, R.A.

    2009-01-01

    BACKGROUND: Previous studies of inter-practice variation of the prevalence of hypertension and diabetes mellitus showed wide variations between practices. However, in these studies inter-practice variation was calculated without controlling for clustering of patients within practices and without

  4. Tissue Doppler echocardiography in persons with hypertension, diabetes, or ischaemic heart disease: the Copenhagen City Heart Study

    Mogelvang, Rasmus; Sogaard, Peter; Pedersen, Sune A

    2009-01-01

    AIMS: To test the hypothesis that echocardiographic tissue Doppler imaging (TDI) reveals reduced myocardial function in hypertension, diabetes, and ischaemic heart disease (IHD) in the general population. METHODS AND RESULTS: Within a large, community-based population study, cardiac function...... and diastolic cardiac function in hypertension [n = 345; LD 10.1 (+/-standard deviation, SD 2.0 mm), P diabetes [n = 65; LD 9.8 (+/-SD 2.2 mm), P ....001] compared with controls [n = 533; LD 11.4 (+/-SD 2.0 mm); E/e' 9.0 (x/SD 1.3)]. This pattern remained significant after adjusting for age, sex, body mass index, heart rate, and the results of conventional echocardiography. CONCLUSION: In the general population, persons with hypertension, diabetes, or IHD...

  5. Study on the inter-relationship among the changes of serum levels of leptin, insulin and glucagon in patients with DM2 complicated with hypertension

    Zeng Zhiwei; Yan Songqin; Tan Wei

    2006-01-01

    Objective: To investigate the inter-relationship among the changes of serum leptin, insulin and glucagon levels in patients with type 2 diabetes mellitus (DM2) complicated with hypertension. Methods: Serum leptin, insulin and glucagon levels were, measured with RIA in 30 DM2 patients complicated with hypertension, 30 DM2 patients without hypertension and 30 controls. Results: Serum levels of leptin, insulin and glucagon in all the DM2 patients were significantly higher than those in controls (P<0.01). In addition, the serum levels in DM2 patients with hypertension were significantly higher than those in DM2 patients without hypertension (P<0.05). These levels were positively correlated with the severity of hypertension. Conclusion: The role played by leptin and glucagon in the pathogenesis of type 2 diabetes mellitns should be furthur studied. (authors)

  6. Healthful Dietary Patterns and the Risk of Hypertension Among Women With a History of Gestational Diabetes Mellitus: A Prospective Cohort Study.

    Li, Shanshan; Zhu, Yeyi; Chavarro, Jorge E; Bao, Wei; Tobias, Deirdre K; Ley, Sylvia H; Forman, John P; Liu, Aiyi; Mills, James; Bowers, Katherine; Strøm, Marin; Hansen, Susanne; Hu, Frank B; Zhang, Cuilin

    2016-06-01

    Women who developed gestational diabetes mellitus represent a high-risk population for hypertension later in life. The role of diet in the progression of hypertension among this susceptible population is unknown. We conducted a prospective cohort study of 3818 women with a history of gestational diabetes mellitus in the Nurses' Health Study II as part of the ongoing Diabetes & Women's Health Study. These women were followed-up from 1989 to 2011. Incident hypertension was identified through self-administered questionnaires that were validated previously by medical record review. Adherence scores for the alternative Healthy Eating Index 2010, the alternative Mediterranean diet, and the Dietary Approaches to Stop Hypertension were computed for each participant. Cox proportional hazard models were used to evaluate the associations between dietary scores and hypertension while adjusting for major risk factors for hypertension. We documented 1069 incident hypertension cases during a median of 18.5 years of follow-up. After adjustment for major risk factors for hypertension, including body mass index, alternative Healthy Eating Index 2010, alternative Mediterranean diet, and Dietary Approaches to Stop Hypertension scores were significantly inversely associated with the risk of hypertension; hazard ratio and 95% confidence interval comparing the extreme quartiles (highest versus lowest) were 0.76 (0.61-0.94; P for linear trend =0.03) for AHEI score, 0.72 (0.58-0.90; P for trend =0.01) for Dietary Approach to Stop Hypertension score, and 0.70 (0.56-0.88; P for trend =0.002) for alternative Mediterranean diet score. Adherence to a healthful dietary pattern was related to a lower subsequent risk of developing hypertension among women with a history of gestational diabetes mellitus. © 2016 American Heart Association, Inc.

  7. [Epidemiological study of hypertension in Dongxiang population of Dongxiang county in Gansu province].

    Li, X H; Qiao, Y; Xie, P; Ma, H Z; Ma, Y A

    2016-09-24

    Objective: To investigate the prevalence, awareness, treatment and control rate of hypertension among Dongxiang population of Dongxiang county in Gansu province, and analyze risk factors of hypertension in this population. Methods: A total of 1 879 Dongxiang residents of Dongxiang county in Gansu province aged 18 years and over were selected in one town and eight villages by random cluster method from April to June in 2014. All subjects were interviewed and physical examination including blood pressure measurement was performed. Multivariate logistic regression analysis was used to analyze the risk factors of hypertension. Results: Prevalence of hypertension in this population was 21.4%(402/1 879). Prevalence of hypertension increased with aging and was 7.9%(35/441) in 18-39 years old people, and 20.2%(151/749)in 40-59 years old people, and 31.3%(216/689)in ≥60 years old people ( P old group (8.0%(20/249)vs. 7.8%(15/192), P >0.05) and 40-59 years old group (19.8%(78/393) vs. 20.5%(73/356), P >0.05), while the prevalence of hypertension was significantly higher in male than in female(34.2%(123/360) vs. 28.3%(93/329), P old group. Prevalence of hypertension was also significantly higher in rural area residents than in county town residents (23.4%(255/1 090) vs.18.6%(147/789), P county residents. Multivariate logistic regression analysis showed that age, family history of hypertension, high body mass index, less physical activity and more static state were risk factors of hypertension in this population( P county in Gansu province. Hypertension prevention focusing on risk factors control and treatment strategies should be enhanced in this population.

  8. Neonatal hypertension.

    Sharma, Deepak; Farahbakhsh, Nazanin; Shastri, Sweta; Sharma, Pradeep

    2017-03-01

    Neonatal hypertension (HT) is a frequently under reported condition and is seen uncommonly in the intensive care unit. Neonatal HT has defined arbitrarily as blood pressure more than 2 standard deviations above the base as per the age or defined as systolic BP more than 95% for infants of similar size, gestational age and postnatal age. It has been diagnosed long back but still is the least studied field in neonatology. There is still lack of universally accepted normotensive data for neonates as per gestational age, weight and post-natal age. Neonatal HT is an important morbidity that needs timely detection and appropriate management, as it can lead to devastating short-term effect on various organs and also poor long-term adverse outcomes. There is no consensus yet about the treatment guidelines and majority of treatment protocols are based on the expert opinion. Neonate with HT should be evaluated in detail starting from antenatal, perinatal, post-natal history, and drug intake by neonate and mother. This review article covers multiple aspects of neonatal hypertension like definition, normotensive data, various etiologies and methods of BP measurement, clinical features, diagnosis and management.

  9. Left ventricular filling patterns in patients with systemic hypertension and left ventricular hypertrophy (the LIFE study). Losartan Intervention For Endpoint

    Wachtell, K; Smith, G; Gerdts, E

    2000-01-01

    Abnormal left ventricular (LV) filling may exist in early stages of hypertension. Whether this finding is related to LV hypertrophy is currently controversial. This study was undertaken to assess relations between abnormal diastolic LV filling and LV geometry in a large series of hypertensive...... (sex-adjusted Cornell voltage duration criteria or Sokolow-Lyon voltage criteria) after 14 days of placebo treatment. The patients' mean age was 67+/-7 years and 44% were women. One hundred forty patients (19%) had normal LV geometric pattern, 79 (11%) had concentric remodeling, 342 (45%) had eccentric...

  10. Cervical Spondylosis and Hypertension

    Peng, Baogan; Pang, Xiaodong; Li, Duanming; Yang, Hong

    2015-01-01

    Abstract Cervical spondylosis and hypertension are all common diseases, but the relationship between them has never been studied. Patients with cervical spondylosis are often accompanied with vertigo. Anterior cervical discectomy and fusion is an effective method of treatment for cervical spondylosis with cervical vertigo that is unresponsive to conservative therapy. We report 2 patients of cervical spondylosis with concomitant cervical vertigo and hypertension who were treated successfully with anterior cervical discectomy and fusion. Stimulation of sympathetic nerve fibers in pathologically degenerative disc could produce sympathetic excitation, and induce a sympathetic reflex to cause cervical vertigo and hypertension. In addition, chronic neck pain could contribute to hypertension development through sympathetic arousal and failure of normal homeostatic pain regulatory mechanisms. Cervical spondylosis may be one of the causes of secondary hypertension. Early treatment for resolution of symptoms of cervical spondylosis may have a beneficial impact on cardiovascular disease risk in patients with cervical spondylosis. PMID:25761188

  11. Variation in medication adherence across patient behavioral segments: a multi-country study in hypertension

    Sandy R

    2015-10-01

    Full Text Available Robert Sandy, Ulla Connor CoMac Analytics, Inc, Providence, RI, USA Objectives: This study determines the following for a hypertensive patient population: 1 the prevalence of patient worldview clusters; 2 differences in medication adherence across these clusters; and 3 the adherence predictive power of the clusters relative to measures of patients’ concerns over their medication’s cost, side effects, and efficacy. Methods: Members from patient panels in the UK, Germany, Italy, and Spain were invited to participate in an online survey that included the Medication Adherence Report Scale-5 (MARS-5 adherence instrument and a patient segmentation instrument developed by CoMac Analytics, Inc, based on a linguistic analysis of patient talk. Subjects were screened to have a diagnosis of hypertension and treatment with at least one antihypertensive agent. Results: A total of 353 patients completed the online survey in August/September 2011 and were categorized against three different behavioral domains: 1 control orientation (n=176 respondents [50%] for I, internal; n=177 respondents [50%] for E, external; 2 emotion (n=100 respondents [28%] for P, positive; n=253 respondents [72%] for N, negative; and 3 agency or ability to act on choices (n=227 respondents [64%] for H, high agency; n=126 [36%] for L, low agency. Domains were grouped into eight different clusters with EPH and IPH being the most prevalent (88 respondents [25%] in each cluster. The prevalence of other behavior clusters ranged from 6% (22 respondents, INH to 12% (41 respondents, IPL. The proportion of patients defined as perfectly adherent (scored 25 on MARS-5 varied sharply across the segments: 51% adherent (45 of 88 respondents for the IPH vs 8% adherent (2 of 25 respondents classified as INL. Side effects, being employed, and stopping medicine because the patient got better were all significant determinants of adherence in a probit regression model. Conclusion: By categorizing

  12. ABO and RhD blood groups and gestational hypertensive disorders: a population-based cohort study.

    Lee, B K; Zhang, Z; Wikman, A; Lindqvist, P G; Reilly, M

    2012-09-01

    To examine the association between ABO and RhD blood groups and gestational hypertensive disorders in a large population-based cohort. Cohort study. Risks of gestational hypertensive disorders, pre-eclampsia, and severe pre-eclampsia, estimated by odds ratios for maternal ABO blood group and RhD status. National health registers of Sweden. All singleton deliveries in Sweden born to first-time mothers during the period 1987-2002 [total n = 641 926; any gestational hypertensive disorders, n = 39 011 (6.1%); pre-eclampsia cases, n = 29 337 (4.6%); severe pre-eclampsia cases, n = 8477 (1.3%)]. Using blood group O as a reference, odds ratios of gestational hypertensive disorders, pre-eclampsia, and severe pre-eclampsia were obtained from logistic regression models adjusted for potential confounding factors. Gestational hypertensive disorders, pre-eclampsia, and severe pre-eclampsia. Compared with blood group O, all non-O blood groups had modest but statistically significantly higher odds of pre-eclampsia. Blood group AB had the highest risk for pre-eclampsia (OR = 1.10, 95% CI 1.04-1.16) and severe pre-eclampsia (OR = 1.18, 95% CI 1.07-1.30). RhD-positive mothers had a small increased risk for pre-eclampsia (OR = 1.07, 95% CI 1.03-1.10). In the largest study on this topic to date, women with AB blood group have the highest risks of gestational hypertensive disorders, pre-eclampsia, and severe pre-eclampsia, whereas women with O blood group have the lowest risks of developing these disorders. Although the magnitude of increased risk is small, this finding may help improve our understanding of the etiology of pre-eclampsia. © 2012 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2012 RCOG.

  13. Endothelial nitric oxide synthase gene polymorphisms and cardiovascular damage in hypertensive subjects: an Italian case-control study

    Pizzo Federica

    2008-05-01

    Full Text Available Abstract Background Nitric oxide (NO synthesized by endothelial nitric oxide synthase (eNOS plays an important role in regulation of endothelial function and in the control of blood pressure. However, the results from some studies on the association between three clinically relevant eNOS gene polymorphisms (G894T, T786C and intron 4b/a and essential hypertension are unclear. We designed a case-control study to evaluate the influence of eNOS polymorphisms on target organ damage in 127 hypertensives and 67 normotensives. Clinical evaluation, biochemical parameters, Urinary Albumin Excretion (UAE and echocardiogram were performed to characterize target organ damage. eNOS polymorphism were recognized by PCR method. Results The distribution of eNOS genotypes was similar in hypertensives and normotensives but 4aa was present in the 2.5% of hypertensives and completely absent in normotensives. Subjects with 4bb, G894T, and T786C genotypes showed an increased prevalence of target organ damage. Moreover prevalence of G894T and introne 4 variants was significantly higher in hypertensives than in normotensives both with cardiovascular damage. Logistic regression analysis didn't show any association between eNOS polymorphisms, Body Mass Index (BMI, hypertension, gender and cardiovascular damage. Only the age (OR 1.11; IC 95% 1.06–1.18 was predictive of cardiovascular damage in our population. Conclusion Our results seem to indicate a lack of association with eNOS variants and cardiovascular damage onset.

  14. Acute and chronic effects of aerobic exercise on blood pressure in resistant hypertension: study protocol for a randomized controlled trial.

    Nascimento, L S; Santos, A C; Lucena, Jms; Silva, Lgo; Almeida, Aem; Brasileiro-Santos, M S

    2017-06-02

    Resistant hypertension is a specific condition that affects approximately 10% of subjects with hypertension, and is characterized by persistently high blood pressure levels even using therapy of three or more antihypertensive agents or with blood pressure control using therapy with four or more antihypertensive agents. Changes in lifestyle, such as physical exercise, are indicated for controlling blood pressure. However, investigating studies about this therapy in individuals with resistant hypertension are few. This is a randomized controlled clinical trial. Forty-eight patients with resistant hypertension will be submitted to perform four short-term interventions: aerobic exercise sessions (mild-, moderate- and high-intensity) and control session, in random order and on separate days. After the short-term sessions, the patients will be randomly allocated into four groups for 8 weeks of follow-up: mild-, moderate- and high-intensity aerobic exercise, and a control group. The primary outcome is the occurrence of blood pressure reduction (office and ambulatory analysis, and acute and chronic effects). Secondary outcomes are autonomic and hemodynamic mechanisms: cardiac and vasomotor autonomic modulation, spontaneous baroreflex sensitivity, forearm blood flow and vascular resistance. The importance of exercise for hypertension has been known for decades, but little is known about the effects on patients with resistant hypertension. This study will help to understand whether different aerobic exercise intensities can induce different responses, as well as by what mechanisms adjustments in blood pressure levels may occur. ClinicalTrials.gov, ID: NCT02670681 . Registered on 28 January 2016 (first version); Brazilian Registry Platform Clinical Trials: protocol RBR-5q24zh . Registered on 24 June 2015.

  15. Cognitive impairment and hypertension in older adults living in extreme poverty: a cross-sectional study in Peru

    Maria Lazo-Porras

    2017-10-01

    Full Text Available Abstract Background Previous studies have shown that hypertension is a risk factor for cognitive impairment, but whether this association is also present in extremely poor populations in Low Middle Income Countries settings remains to be studied. Understanding other drivers of cognitive impairment in this unique population also merits attention. Methods We performed a secondary analysis using data from the “Encuesta de Salud y Bienestar del Adulto Mayor”, a regional survey conducted in an extremely poor population of people older than 65 years old from 12 Peruvian cities in 2012. The outcome variable was cognitive impairment, determined by a score of ≤7 in the modified Mini-Mental State Examination. The exposure was self-reported hypertension status. Variables such as age, gender, controlled hypertension, education level, occupation, depression and area of living (rural/urban were included in the adjusted analysis. We used Poisson regression with robust variance to calculate prevalence ratios (PR and 95% confidence interval (95% CI adjusting for confounders. Results Data from 3842 participants was analyzed, 51.8% were older than 70 years, and 45.6% were females. The prevalence of cognitive impairment was 1.7% (95% CI 1.3%–2.1%. There was no significant difference on the prevalence of cognitive impairment between the group of individuals with hypertension in comparison with those without hypertension (PR = 0.64, 95% CI 0.33–1.23. Conclusions The association described between hypertension and cognitive impairment was not found in a sample of extremely poor Peruvian older adults.

  16. Cognitive impairment and hypertension in older adults living in extreme poverty: a cross-sectional study in Peru.

    Lazo-Porras, Maria; Ortiz-Soriano, Victor; Moscoso-Porras, Miguel; Runzer-Colmenares, Fernando M; Málaga, German; Jaime Miranda, J

    2017-10-26

    Previous studies have shown that hypertension is a risk factor for cognitive impairment, but whether this association is also present in extremely poor populations in Low Middle Income Countries settings remains to be studied. Understanding other drivers of cognitive impairment in this unique population also merits attention. We performed a secondary analysis using data from the "Encuesta de Salud y Bienestar del Adulto Mayor", a regional survey conducted in an extremely poor population of people older than 65 years old from 12 Peruvian cities in 2012. The outcome variable was cognitive impairment, determined by a score of ≤7 in the modified Mini-Mental State Examination. The exposure was self-reported hypertension status. Variables such as age, gender, controlled hypertension, education level, occupation, depression and area of living (rural/urban) were included in the adjusted analysis. We used Poisson regression with robust variance to calculate prevalence ratios (PR) and 95% confidence interval (95% CI) adjusting for confounders. Data from 3842 participants was analyzed, 51.8% were older than 70 years, and 45.6% were females. The prevalence of cognitive impairment was 1.7% (95% CI 1.3%-2.1%). There was no significant difference on the prevalence of cognitive impairment between the group of individuals with hypertension in comparison with those without hypertension (PR = 0.64, 95% CI 0.33-1.23). The association described between hypertension and cognitive impairment was not found in a sample of extremely poor Peruvian older adults.

  17. Gaseous air pollution and emergency hospital visits for hypertension in Beijing, China: a time-stratified case-crossover study

    Zhang Yanshen

    2010-10-01

    Full Text Available Abstract Background A number of epidemiological studies have been conducted to research the adverse effects of air pollution on mortality and morbidity. Hypertension is the most important risk factor for cardiovascular mortality. However, few previous studies have examined the relationship between gaseous air pollution and morbidity for hypertension. Methods Daily data on emergency hospital visits (EHVs for hypertension were collected from the Peking University Third Hospital. Daily data on gaseous air pollutants (sulfur dioxide (SO2 and nitrogen dioxide (NO2 and particulate matter less than 10 μm in aerodynamic diameter (PM10 were collected from the Beijing Municipal Environmental Monitoring Center. A time-stratified case-crossover design was conducted to evaluate the relationship between urban gaseous air pollution and EHVs for hypertension. Temperature and relative humidity were controlled for. Results In the single air pollutant models, a 10 μg/m3 increase in SO2 and NO2 were significantly associated with EHVs for hypertension. The odds ratios (ORs were 1.037 (95% confidence interval (CI: 1.004-1.071 for SO2 at lag 0 day, and 1.101 (95% CI: 1.038-1.168 for NO2 at lag 3 day. After controlling for PM10, the ORs associated with SO2 and NO2 were 1.025 (95% CI: 0.987-1.065 and 1.114 (95% CI: 1.037-1.195, respectively. Conclusion Elevated urban gaseous air pollution was associated with increased EHVs for hypertension in Beijing, China.

  18. Mineralocorticoid hypertension

    Vishal Gupta

    2011-01-01

    Full Text Available Hypertension affects about 10 - 25% of the population and is an important risk factor for cardiovascular and renal disease. The renin-angiotensin system is frequently implicated in the pathophysiology of hypertension, be it primary or secondary. The prevalence of primary aldosteronism increases with the severity of hypertension, from 2% in patients with grade 1 hypertension to 20% among resistant hypertensives. Mineralcorticoid hypertension includes a spectrum of disorders ranging from renin-producing pathologies (renin-secreting tumors, malignant hypertension, coarctation of aorta, aldosterone-producing pathologies (primary aldosteronism - Conns syndrome, familial hyperaldosteronism 1, 2, and 3, non-aldosterone mineralocorticoid producing pathologies (apparent mineralocorticoid excess syndrome, Liddle syndrome, deoxycorticosterone-secreting tumors, ectopic adrenocorticotropic hormones (ACTH syndrome, congenitalvadrenal hyperplasia, and drugs with mineraocorticoid activity (locorice, carbenoxole therapy to glucocorticoid receptor resistance syndromes. Clinical presentation includes hypertension with varying severity, hypokalemia, and alkalosis. Ratio of plasma aldosterone concentraion to plasma renin activity remains the best screening tool. Bilateral adrenal venous sampling is the best diagnostic test coupled with a CT scan. Treatment is either surgical (adrenelectomy for unilateral adrenal disease versus medical therapy for idiopathic, ambiguous, or bilateral disease. Medical therapy focuses on blood pressure control and correction of hypokalemia using a combination of anti-hypertensives (calcium channel blockers, angiotensin converting enzyme inhibitors, or angiotensin receptor blockers and potassium-raising therapies (mineralcorticoid receptor antagonist or potassium sparing diuretics. Direct aldosterone synthetase antagonists represent a promising future therapy.

  19. Hypertension prevalence, awareness, treatment and its correlates among people 35 years and older: Result from pilot phase of the Azar cohort study.

    Ghorbani, Zohreh; Shamshirgaran, Seyed Morteza; Ghaffari, Samad; Sarbakhsh, Parvin; Najafipour, Farzad; Aminisani, Nayyereh

    2018-01-01

    There is remarkable alteration in hypertension prevalence and awareness, and their correlates among various geographic locations and ethnic groups. The aim of this study was to report hypertension prevalence, awareness, and its correlates as well as hypertension treatment, and control among Azari people aged 35 years and older. The pilot phase of the Azar Cohort Study; a state level of a nationwide PERSIAN cohort study was conducted in Khameneh city between October 2014 and January 2015. All people 35 years of age and above were invited to take part in this study. A comprehensive range of different biomarkers, lifestyle, socioeconomic factors, and health-related factors was collected. Blood pressure was measured by a trained nurse/midwife. Descriptive statistical methods were used to present general characteristics of the study population as frequency tables. Separate multiple logistic regression models were built to assess the predictors of hypertension prevalence. A total of 1038 people were included in this study. The overall prevalence of hypertension was 22.9%. Awareness of hypertension was 60.5% and in those with known hypertension, 84% were using the antihypertensive medications, of those 68.5% had controlled hypertension. After adjustment; age (odds ratios [OR] adj = 1.12 95% confidence interval [CI]: 1.09-1.15), gender (OR adj = 1.65 95% CI: 1.08-2.51), obesity OR adj = 2.51 (1.40-4.88), waist-to-hip ratio (WHR) (OR adj = 1.70 (1.05-2.75), and comorbidities (OR adj = 2.51 (1.72-3.66) were independent predictors of hypertension. Age, sex, body mass index, WHR, and comorbidities were known as predictors of hypertension in this study, health promotion strategies including lifestyle modification to reduce overweight/obesity and secondary prevention programs for early detection of hypertension in high-risk groups according to age, gender, and disease profile are recommended.

  20. Heart and Stroke Foundation of Ontario (HSFO high blood pressure strategy's hypertension management initiative study protocol

    Von Sychowski Shirley

    2008-12-01

    Full Text Available Abstract Background Achieving control of hypertension prevents target organ damage at both the micro and macrovascular level and is a highly cost effective means of lowering the risk for heart attack and stroke particularly in people with diabetes. Clinical trials demonstrate that blood pressure control can be achieved in a large proportion of people. Translating this knowledge into widespread practice is the focus of the Hypertension Management Initiative, which began in 2004 with the goal of improving the management of this chronic health condition by primary care providers and patients in the community. Methods This study will test the effect of a systems change on the management of high blood pressure in real world practice in primary care in Ontario, Canada. The systems change intervention involves an interprofessional educational program bringing together physicians, nurses and pharmacists with tools for both providers and patients to facilitate blood pressure management. Each of two waves of subjects were enrolled over a 6 month period with the initial enrollment between waves separated by 9 months. Blood pressure will be measured with the BpTru ® automated blood pressure device. To determine the effectiveness of the intervention, a before and after analysis within all subjects will compare blood pressure at baseline to annual measurements for the three year study. To assess whether the intervention has an impact on blood pressure control independent of community trends, a betwen group comparison of baseline blood pressures in the delayed wave will be made with the immediate wave during the same time period, so that the immediate wave has experienced the intervention for at least 9 months. The total enrollment goal is 5,000 subjects. The practice locations include 10 Family Health Teams (FHTs and 1 Community Health Centre (CHC and approximately 49 primary care physicians, 15 nurse practitioners, 37 registered nurses and over 150

  1. Effectiveness of interventions for hypertension care in the community – a meta-analysis of controlled studies in China

    Lu Zuxun

    2012-07-01

    Full Text Available Abstract Background Hypertension is a serious public health problem in China and in other developing countries. Our aim is to conduct a systematic review of studies on the effectiveness of community interventions for hypertension management in China. Methods China National Knowledge Infrastructure, PubMed, and references of retrieved articles were searched to identify randomised or quasi-randomised controlled studies that evaluated community hypertension care in mainland China. One reviewer extracted and a second reviewer checked data from the included studies. Results We included 94 studies, 93 of which were in Chinese language, that evaluated the following interventions: health education, improved monitoring, family-support, self-management, healthcare management changes and training of providers. The study quality was generally poor, with high risk of biased outcome reporting and significant heterogeneity between studies. When reported, the vast majority of the included studies reported statistically significantly improved outcomes in the intervention group. By assuming zero treatment effects for missing outcomes, the weighted reduction in the intervention group was 6∙9 (95% CI: 4∙9 to 8∙9 mm Hg for systolic BP, and 3∙8 (95% CI: 2∙6 to 5∙0 mm Hg for diastolic BP. Exploratory subgroup analyses found no significant differences between different interventions. Conclusions After taking account of possible reporting biases, a wide range of community interventions for hypertension care remain effective. The findings have implications for China and other low and middle income countries facing similar challenges. Because of significant heterogeneity and high risk of bias in the available studies, further well designed studies should be conducted in China to provide high quality evidence to inform policy decisions on hypertension control.

  2. Living with pulmonary hypertension: unique insights from an international ethnographic study.

    Kingman, Martha; Hinzmann, Barbara; Sweet, Oliver; Vachiéry, Jean-Luc

    2014-05-16

    To better understand the patient's perspective of pulmonary hypertension (PH), including the impact of living with PH, disease management and treatment. This qualitative ethnographic study collected observational video footage, supplemented by field notes and patient diaries to assess the impact of PH on the patient's life. Patients were observed and filmed in their home for up to 6 h, capturing the environment, interactions and activities of everyday life. Patients with pulmonary arterial hypertension (PAH) or chronic thromboembolic PH who were receiving PAH-specific medication were recruited through healthcare professionals (HCPs) and patient associations in seven countries across four continents. Sampling was purposive and subgroup analysis was not intended. Overall, 39 patients with PH were enrolled. Many patients had a poor understanding of PH and found their 'invisible' disease difficult to explain to others. An important finding was the secrecy surrounding PH. Feelings of insecurity and isolation were regularly reported, and many patients admitted to hiding their symptoms. The marked improvement in symptoms after therapy initiation made assessment of disease progression more difficult as patients compared their quality of life (QoL) against pretreatment levels. Extensive planning and adherence to daily routines were required in patients' everyday life. Ethnography was used for the first time, in several countries, to evaluate the patient's perception of living with PH. This approach revealed key findings that would not typically be uncovered using other qualitative techniques, including the secrecy surrounding PH, the difficulties in describing the disease and the challenges in assessing disease progression. A more tailored dissemination of information from HCPs and development of a simple and understandable PH definition may be beneficial in alleviating the secrecy reported by patients. A greater appreciation of how patients perceive their disease and Qo

  3. The effects of dihydropyridine and phenylalkylamine calcium antagonist classes on autonomic function in hypertension : The VAMPHYRE study

    Lefrandt, JD; Heitmann, J; Sevre, K; Castellano, M; Hausberg, M; Fallon, M; Fluckiger, L; Urbigkeit, A; Rostrup, M; Agabiti-Rosei, E; Rahn, KH; Murphy, M; Zannad, F; de Kam, PJ; van Roon, AM; Smit, AJ

    The aim of the present study was to compare the effects of a long-acting dihydropyridine (amlodipine) and a nondihydropyridine. (verapamil) on autonomic function in patients with mild to moderate hypertension. A total of 145 patients with a diastolic blood pressure (BP) between 95 and 110 mm Hg

  4. Trends and determinant factors in hypertension control in a population study with 25 years of follow-up

    Andersen, Ulla O; Jensen, Gorm B

    2010-01-01

    OBJECTIVE: The present study focused on trend in hypertension control and on determinant factors that may influence efficacy in antihypertensive therapy. Two measures of treatment efficacy were used: population blood pressure and the relative frequency of effectively treated patients (blood press...

  5. Results of a hypertension and diabetes treatment program in the slums of Nairobi: a retrospective cohort study

    Werner, Marie E.; van de Vijver, Steven; Adhiambo, Mildred; Egondi, Thaddaeus; Oti, Samuel O.; Kyobutungi, Catherine

    2015-01-01

    Cardiovascular diseases (CVD) are the world's leading cause of death and their prevalence is rising. Diabetes and hypertension, major risk factors for CVD, are highly prevalent among the urban poor in Africa, but treatment options are often limited in such settings. This study reports on the results

  6. Urinary Magnesium Excretion and Risk of Hypertension The Prevention of Renal and Vascular End-Stage Disease Study

    Joosten, Michel M.; Gansevoort, Ron T.; Mukamal, Kenneth J.; Kootstra-Ros, J.E.; Feskens, Edith J. M.; Geleijnse, Johanna M.; Navis, Gerjan; Bakker, Stephan J. L.

    Observational studies on dietary or circulating magnesium and risk of hypertension have reported weak-to-modest inverse associations, but have lacked measures of actual dietary uptake. Urinary magnesium excretion, an indicator of intestinal magnesium absorption, may provide a better insight in this

  7. Urinary magnesium excretion and risk of hypertension. The prevention of renal and vascular end-stage disease study

    Joosten, M.M.; Gansevoort, R.T.; Mukamal, K.J.; Kootstra-Ros, J.E.; Feskens, E.J.M.; Geleijnse, J.M.; Navis, G.; Bakker, S.J.L.

    2013-01-01

    Observational studies on dietary or circulating magnesium and risk of hypertension have reported weak-to-modest inverse associations, but have lacked measures of actual dietary uptake. Urinary magnesium excretion, an indicator of intestinal magnesium absorption, may provide a better insight in this

  8. Association of anxiety and depression with hypertension control: a US multidisciplinary group practice observational study.

    Ho, Aaron K; Thorpe, Carolyn T; Pandhi, Nancy; Palta, Mari; Smith, Maureen A; Johnson, Heather M

    2015-11-01

    The presence of a mental health disorder with hypertension is associated with higher cardiovascular disease mortality than hypertension alone. Although earlier detection of hypertension has been demonstrated in patients with anxiety and depression, the relationship of mental health disorders to hypertension control is unknown. Our objective was to evaluate rates and predictors of incident hypertension control among patients with anxiety and/or depression compared with patients without either mental health diagnosis. A 4-year retrospective analysis included 4362 patients, at least 18 years old, who received primary care in a large academic group practice from 2008 to 2011. Patients met The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure criteria and had a hypertension diagnosis. Kaplan-Meier analysis estimated the probability of achieving control for patients with and without anxiety and/or depression. Cox proportional hazard models were fit to identify predictors of time to control. Overall, 13% (n = 573) had a baseline diagnosis of anxiety and/or depression. Those with anxiety and/or depression demonstrated more primary care and specialty visits than those without either condition. After adjustment, patients with anxiety and/or depression had faster rates of hypertension control (hazard ratio [HR] 1.22; 1.07-1.39] than patients without either diagnosis. Other associations of faster hypertension control included female gender (HR 1.32; 1.20-1.44), absence of tobacco use (HR 1.17; 1.03-1.33), Medicaid use (HR 1.27; 1.09-1.49), and a higher Adjusted Clinical Group Risk Score (HR 1.13; 1.10-1.17), a measure of healthcare utilization. Greater healthcare utilization among patients with anxiety and/or depression may contribute to faster hypertension control.

  9. Epicardial adipose tissue volume a diagnostic study for independent predicting disorder of circadian rhythm of blood pressure in patients with essential hypertension.

    Zhou, L; Deng, Y; Gong, J; Chen, X; Zhang, Q; Wang, J

    2016-05-30

    The aim of the study was to determine whether epicardial adipose tissue volume (EATV), a new cardiometabolic risk factor, is associated with circadian changes of blood pressure (BP) in patients with newly diagnosed essential hypertension. Ninety patients with newly diagnosed essential hypertension underwent ambulatory blood pressure monitoring for 24 h. EATV was measured using cardiac computed tomography. These patients were categorized into three groups according to their BP patterns (group 1, n=46, dipper hypertension, also called normal pattern; group 2, n=24, non-dipper hypertension; group 3, n=20, anti-dipper hypertension; group 2 and 3 are also called abnormal pattern). Data were collected retrospectively and compared between hypertensive patients with normal pattern and abnormal pattern. The normal pattern hypertensive patient had significant lower mean EATV and BP ((EATV, 91.3±29.4 cm3) than those of abnormal pattern patients including group 2 (EATV, 116.2±31.06cm3, EATV, 124.8±28.5cm3, PEATV with abnormal blood pressure mode was 0.500 (pEATV was elevated in newly diagnosed and untreated patients with non-dipper hypertension and anti-dipper hypertension. EATV measured by cardiac computed tomography can be used to indicate the increased risk of circadian rhythm of blood pressure.

  10. Association of serum uric acid and risk of hypertension in adults: a prospective study of Kailuan Corporation cohort.

    Cui, Liu-Fu; Shi, Hui-Jing; Wu, Shou-Ling; Shu, Rong; Liu, Na; Wang, Guan-Ying; Zhou, Bin; Sun, Kai; Yu, Ping; Wang, Jian; Song, Hai-Cheng; Yang, Wen-Hao; Wang, Jie-Rui; Han, Yi-Xuan; Mu, Rong

    2017-05-01

    Whether hyperuricemia is an independent risk factor for hypertension in adults is still under debate. To determine the association between serum uric acid and risk of hypertension in the Chinese population, we conducted a prospective study using the "Kailuan Corporation cohort." A total of 39,233 adult subjects with available data on serum uric acid were enrolled from 2006 to 2007. Subjects with established hypertension were excluded and were then grouped based on the gender and baseline quartile serum uric acid into F1-4 for women and M1-4 for men with F1 and M1 being the lowest quartiles. Incidence of newly described primary hypertension was reevaluated in 2010-2011. The median (interquantile range) baseline uric acid (UA) was 290 (243-344) μmol/L in men and 230 (194-274) μmol/L in women. During a 4-year follow-up period, 12,844 subjects (31.31 %) were newly diagnosed with hypertension. The incidence of hypertension was 14.36, 16.57, 19.06, and 22.35 % in F1 to F4 and 33.64, 33.97, 36.54, and 40.74 % in M1 to M4, respectively. Multiple logistic regression analysis showed that the odds ratios (ORs) of incident hypertension were 1.17 [95 % confidence interval (CI) 1.00-1.37, P = 0.055], 1.24 (95 % CI 1.06-1.45, P = 0.009), and 1.20 (95 % CI 1.02-1.41, P = 0.027) in F2 to F4 compared to the F1 and 0.98 (95 % CI 0.91-1.05, P = 0.534), 1.05 (95 % CI 0.98-1.13, P = 0.190), and 1.13 (95 % CI 1.05-1.22, P = 0.002) in M2 to M4 compared to the M1. Elevated level of serum uric acid is associated with an increased risk of hypertension in adults.

  11. The Effect of Low Volume Interval Training on Resting Blood Pressure in Pre-hypertensive Subjects: A Preliminary Study.

    Skutnik, Benjamin C; Smith, Joshua R; Johnson, Ariel M; Kurti, Stephanie P; Harms, Craig A

    2016-01-01

    Clinically pre-hypertensive adults are at a greater risk of developing hypertension, stiffened arteries, and other cardiovascular risks. Endurance exercise training has been shown to improve elevated resting blood pressure and C-reactive protein (CRP) levels. However, a primary barrier preventing individuals from engaging in regular physical activity is a lack of time. The purpose of our study was to determine if a high-intensity interval training (HIIT) protocol would be as effective as continuous aerobic endurance training (ET) on resting blood pressure in pre-hypertensive participants. Additionally, this study investigated the effects of HIIT vs. ET on CRP. Twelve pre-hypertensive participants (33.3±6.1 yrs; 3M/9W) participated in 8 weeks of cycle ergometer exercise training. The ET exercised for 30 continuous min/day, 4 days/week at 40% VO2max reserve. The HIIT exercised at a 1:1 work-to-rest for 20 min/day, 3 days/week at 60% peak power. Resting mean arterial pressure and CRP were compared throughout the study. Both groups showed decreases (pHIIT: -8.6 ± 4.8 mmHg) following the 8 weeks. For CRP, there was a significant decrease (p=0.014) as a main effect of time. VO2max increased (pHIIT and ET. These preliminary data suggest HIIT and ET similarly decreased resting blood pressure and increased VO2max.

  12. Diminished response to furosemide in I-123 Hippuran renal studies of renovascular hypertension caused by unilateral renal artery stenosis

    Flueckiger, F.M.; Fueger, G.F.; Einspieler, R.; Hausegger, K. (Department of Radiology, Graz (Austria))

    1990-09-01

    Dynamic I-123 Hippuran renal studies to measure furosemide response (FR) were performed in three groups of patients: (1) 57 patients with renovascular hypertension due to a poststenotic, ischemic kidney; (2) 23 patients with essential hypertension; and (3) 50 nonhypertensive patients with healthy kidneys (control group). FR was observed as renal parenchymal tracer washout within 10 minutes after the injection of 40 mg of furosemide. The retention index (RI) took into consideration the renal parenchymal tracer content before and 10 minutes after furosemide injection. In the control group, the FR was greater than 50% and the RI was less than 20. Patients with essential hypertension revealed no differences in the amounts of FR and RI compared with the control group. In renovascular hypertension, the FR was diminished and the RI was raised significantly. The values of FR and RI showed a good correlation to the degree of the renal artery stenosis before and after percutaneous transluminal angioplasty. It is concluded that the stimulation of diuresis with furosemide and its quantification represent an important additional step in the evaluation of dynamic I-123 Hippuran studies to detect renal ischemia.

  13. Hypertension and type 2 diabetes: a cross-sectional study in ...

    Raoul

    2012-03-20

    Mar 20, 2012 ... risk factor for cardiovascular disease, stroke and ischemic heart disease. ... The coexistence of hypertension and type 2 diabetes is a major contributor to .... counseling and behavioral interventions designed to modify lifestyle.

  14. Preliminary studies of pulmonary perfusion scanning in patients with pulmonary hypertension

    Shi Rongfang; Liu Xiujie; Wang Yanqun

    1986-01-01

    A comparative analysis of pulmonary perfusion scanning through cardiac catheterization of 57 patients including 32 patients with congenital heart disease, 8 patients with chronic pulmonary thromboembolism and 7 patients with primary pulmonary hypertension is reported. The lung scintigram obtained with In-113m or Tc-99m-MAA represents the distribution of pulmonary blood. It has been found that the lung scintigram was abnormal in patients of congenital heart disease with pulmonary hypertension (i. e. pulmonary artery pressure between 41-80 mmHg) and the extent of radoiactive regional defects is proportional to the level of pulmonary hypertension. The results of the analysis indicated that pulmonary perfusion scanning being a noninvasive technique would be a useful method in evaluating the level of pulmonary hypertension in patients with left to right shunt before and after surgical operation

  15. Hypertension hos gravide

    Mathiesen, Elisabeth R; Johansen, Marianne; Kamper, Anne Lise

    2009-01-01

    There are four major hypertensive disorders in pregnancy: chronic hypertension, gestational hypertension, preeclampsia and chronic hypertension with superimposed preeclampsia. The indications and efficacy of antihypertensive treatment of the different hypertensive disorders are assessed. Advantages...

  16. Can adverse maternal and perinatal outcomes be predicted when blood pressure becomes elevated? Secondary analyses from the CHIPS (Control of Hypertension In Pregnancy Study) randomized controlled trial

    Magee, Laura A.; von Dadelszen, Peter; Singer, Joel; Lee, Terry; Rey, Evelyne; Ross, Susan; Asztalos, Elizabeth; Murphy, Kellie E.; Menzies, Jennifer; Sanchez, Johanna; Gafni, Amiram; Gruslin, Andrée; Helewa, Michael; Hutton, Eileen; Lee, Shoo K.; Logan, Alexander G.; Ganzevoort, Wessel; Welch, Ross; Thornton, Jim G.; Moutquin, Jean Marie

    2016-01-01

    Introduction. For women with chronic or gestational hypertension in CHIPS (Control of Hypertension In Pregnancy Study, NCT01192412), we aimed to examine whether clinical predictors collected at randomization could predict adverse outcomes. Material and methods. This was a planned, secondary analysis

  17. Fruit and vegetables consumption and incident hypertension: dose-response meta-analysis of prospective cohort studies.

    Wu, L; Sun, D; He, Y

    2016-10-01

    The role of dietary factors on chronic diseases seems essential in the potentially adverse or preventive effects. However, no evidence of dose-response meta-analysis of prospective cohort studies has verified the association between the intake of fruit and/or vegetables and the risk of developing hypertension. The PubMed and Embase were searched for prospective cohort studies. A generic inverse-variance method with random effects model was used to calculate the pooled relative risks (RRs) and 95% confidence intervals (CIs). Generalized least squares trend estimation model was used to calculate the study-specific slopes for the dose-response analyses. Seven articles comprised nine cohorts involving 185 676 participants were assessed. The highest intake of fruit or vegetables separately, and total fruit and vegetables were inversely associated with the incident risk of hypertension compared with the lowest level, and the pooled RRs and 95% CIs were 0.87 (0.79, 0.95), 0.88 (0.79, 0.99) and 0.90 (0.84, 0.98), respectively. We also found an inverse dose-response relation between the risk of developing hypertension and fruit intake, and total fruit and vegetables consumption. The incident risk of hypertension was decreased by 1.9% for each serving per day of fruit consumption, and decreased by 1.2% for each serving per day of total fruit and vegetables consumption. Our results support the recommendation to increase the consumption of fruit and vegetables with respect to preventing the risk of developing hypertension. However, further large prospective studies and long-term high-quality randomized controlled trials are still needed to confirm the observed association.

  18. Study of risk factors affecting both hypertension and obesity outcome by using multivariate multilevel logistic regression models

    Sepedeh Gholizadeh

    2016-07-01

    Full Text Available Background:Obesity and hypertension are the most important non-communicable diseases thatin many studies, the prevalence and their risk factors have been performedin each geographic region univariately.Study of factors affecting both obesity and hypertension may have an important role which to be adrressed in this study. Materials &Methods:This cross-sectional study was conducted on 1000 men aged 20-70 living in Bushehr province. Blood pressure was measured three times and the average of them was considered as one of the response variables. Hypertension was defined as systolic blood pressure ≥140 (and-or diastolic blood pressure ≥90 and obesity was defined as body mass index ≥25. Data was analyzed by using multilevel, multivariate logistic regression model by MlwiNsoftware. Results:Intra class correlations in cluster level obtained 33% for high blood pressure and 37% for obesity, so two level model was fitted to data. The prevalence of obesity and hypertension obtained 43.6% (0.95%CI; 40.6-46.5, 29.4% (0.95%CI; 26.6-32.1 respectively. Age, gender, smoking, hyperlipidemia, diabetes, fruit and vegetable consumption and physical activity were the factors affecting blood pressure (p≤0.05. Age, gender, hyperlipidemia, diabetes, fruit and vegetable consumption, physical activity and place of residence are effective on obesity (p≤0.05. Conclusion: The multilevel models with considering levels distribution provide more precise estimates. As regards obesity and hypertension are the major risk factors for cardiovascular disease, by knowing the high-risk groups we can d careful planning to prevention of non-communicable diseases and promotion of society health.

  19. Dark chocolate and reduced snack consumption in mildly hypertensive adults: an intervention study.

    Koli, Raika; Köhler, Klaus; Tonteri, Elina; Peltonen, Juha; Tikkanen, Heikki; Fogelholm, Mikael

    2015-08-22

    Several studies have shown that cocoa and cocoa-containing foods have the potential to lower blood pressure and improve endothelial function. Most of the studies reporting the beneficial effects of dark chocolate on blood pressure have been short (≤ 4 weeks). The aim of the present 8-wks (weeks) study was to assess the effects of regular consumption of dark chocolate during a reduced snack consumption intervention on blood pressure and other cardiovascular risk factors in mildly hypertensive individuals. This was a randomized, controlled, cross-over trial involving 22 adults (8 women, 14 men), aged 33-64 y, BMI 27.7 ± 3.7 kg/m(2) with mild hypertension. During the intervention period (8-wks) the participants reduced the intake of habitual snacks and replaced them with dark chocolate (49 g/day). In the control period, they only reduced the snacks without any added chocolate. Data (blood lipid profile, glucose, insulin, 24 h blood pressure) was collected in the beginning and end of both periods (intervention and control), and some variables also in the run-in and run-out periods (weight, body fat percentage, blood pressure, arterial stiffness index, diet and physical activity). Daily consumption of dark chocolate had no effects on 24 h blood pressure, resting blood pressure (mean ± SD, pre 142 ± 11.5/89 ± 8.4 mmHg vs. post 142 ± 14.2/88 ± 9.4 mmHg in systolic and diastolic blood pressure, respectively) or arterial stiffness (mean ± SD, pre 7.68 ± 0.88 vs. post 7.76 ± 0.89). Weight was reduced by 1.0 ± 2.2 kg during the control (reduced snack only) period, but was unchanged while eating chocolate (p < 0.027 between the treatments). The data collected in this study indicates that inclusion of dark chocolate daily in the diet had no significant effects on blood pressure or other cardiovascular risk factors during a reduced snack period. ClinicalTrials.gov identifier NCT02130141.

  20. Linkage analysis using co-phenotypes in the BRIGHT study reveals novel potential susceptibility loci for hypertension.

    Wallace, Chris; Xue, Ming-Zhan; Newhouse, Stephen J; Marcano, Ana Carolina B; Onipinla, Abiodun K; Burke, Beverley; Gungadoo, Johannie; Dobson, Richard J; Brown, Morris; Connell, John M; Dominiczak, Anna; Lathrop, G Mark; Webster, John; Farrall, Martin; Mein, Charles; Samani, Nilesh J; Caulfield, Mark J; Clayton, David G; Munroe, Patricia B

    2006-08-01

    Identification of the genetic influences on human essential hypertension and other complex diseases has proved difficult, partly because of genetic heterogeneity. In many complex-trait resources, additional phenotypic data have been collected, allowing comorbid intermediary phenotypes to be used to characterize more genetically homogeneous subsets. The traditional approach to analyzing covariate-defined subsets has typically depended on researchers' previous expectations for definition of a comorbid subset and leads to smaller data sets, with a concomitant attrition in power. An alternative is to test for dependence between genetic sharing and covariates across the entire data set. This approach offers the advantage of exploiting the full data set and could be widely applied to complex-trait genome scans. However, existing maximum-likelihood methods can be prohibitively computationally expensive, especially since permutation is often required to determine significance. We developed a less computationally intensive score test and applied it to biometric and biochemical covariate data, from 2,044 sibling pairs with severe hypertension, collected by the British Genetics of Hypertension (BRIGHT) study. We found genomewide-significant evidence for linkage with hypertension and several related covariates. The strongest signals were with leaner-body-mass measures on chromosome 20q (maximum LOD = 4.24) and with parameters of renal function on chromosome 5p (maximum LOD = 3.71). After correction for the multiple traits and genetic locations studied, our global genomewide P value was .046. This is the first identity-by-descent regression analysis of hypertension to our knowledge, and it demonstrates the value of this approach for the incorporation of additional phenotypic information in genetic studies of complex traits.

  1. Herbal and Alternative Medicine Use in Tanzanian Adults Admitted with Hypertension-Related Diseases: A Mixed-Methods Study

    Anthony Liwa

    2017-01-01

    Full Text Available Background. Hypertension is increasingly common in sub-Saharan Africa where traditional medicine use is also common. We conducted a hospital-based, mixed-methods study to determine prevalence, pattern, and correlates of herbal and alternative medicine use in Tanzanian adults hospitalized with hypertension. Methods. A standardized questionnaire was administered. In-depth interviews were performed on a subset of participants. Factors associated with herbal medicine use were determined by logistic regression. The association between traditional medicine uses and allopathic medication adherence was determined using ordinal logistic regression. Qualitative data were analyzed according to grounded theory. Results. Of 213 adults enrolled, 52 (24.4% reported using herbs during the previous month and 47 (22.1% reported concurrent use of herbs and allopathic medicines. Lower educational level, nonprofessional employment, and lack of health insurance were significantly associated with herbal medicine use. Alternative medicines use was not associated with lower medication adherence. Qualitative interviews identified several important themes including reasons for herbal medicine use. Conclusion. The use of traditional medicines is very common among patients with hypertension. Adults from low socioeconomic status, those with misunderstandings about hypertension, and those without health insurance were more likely to take herbs. Open, nonjudgmental communication between healthcare workers and patients regarding use of traditional medicines must be encouraged in Africa.

  2. Herbal and Alternative Medicine Use in Tanzanian Adults Admitted with Hypertension-Related Diseases: A Mixed-Methods Study

    Roediger, Rebecca; Jaka, Hyasinta; Bougaila, Amina; Smart, Luke; Langwick, Stacey

    2017-01-01

    Background Hypertension is increasingly common in sub-Saharan Africa where traditional medicine use is also common. We conducted a hospital-based, mixed-methods study to determine prevalence, pattern, and correlates of herbal and alternative medicine use in Tanzanian adults hospitalized with hypertension. Methods A standardized questionnaire was administered. In-depth interviews were performed on a subset of participants. Factors associated with herbal medicine use were determined by logistic regression. The association between traditional medicine uses and allopathic medication adherence was determined using ordinal logistic regression. Qualitative data were analyzed according to grounded theory. Results Of 213 adults enrolled, 52 (24.4%) reported using herbs during the previous month and 47 (22.1%) reported concurrent use of herbs and allopathic medicines. Lower educational level, nonprofessional employment, and lack of health insurance were significantly associated with herbal medicine use. Alternative medicines use was not associated with lower medication adherence. Qualitative interviews identified several important themes including reasons for herbal medicine use. Conclusion The use of traditional medicines is very common among patients with hypertension. Adults from low socioeconomic status, those with misunderstandings about hypertension, and those without health insurance were more likely to take herbs. Open, nonjudgmental communication between healthcare workers and patients regarding use of traditional medicines must be encouraged in Africa. PMID:28634545

  3. Influence of arterial hypertension, type 2 diabetes and cardiovascular risk factors on ALS outcome: a population-based study.

    Moglia, Cristina; Calvo, Andrea; Canosa, Antonio; Bertuzzo, Davide; Cugnasco, Paolo; Solero, Luca; Grassano, Maurizio; Bersano, Enrica; Cammarosano, Stefania; Manera, Umberto; Pisano, Fabrizio; Mazzini, Letizia; Dalla Vecchia, Laura A; Mora, Gabriele; Chiò, Adriano

    2017-11-01

    To assess the prognostic influence of pre-morbid type 2 diabetes mellitus, arterial hypertension and cardiovascular (CV) risk profile on ALS phenotype and outcome in a population-based cohort of Italian patients. A total of 650 ALS patients from the Piemonte/Valle d'Aosta Register for ALS, incident in the 2007-2011 period, were recruited. Information about premorbid presence of type 2 diabetes mellitus, arterial hypertension was collected at the time of diagnosis. Patients' CV risk profile was calculated according to the Joint British Societies' guidelines on prevention of cardiovascular disease in clinical practice (JBS2). At the univariate analysis, the presence of pre-morbid arterial hypertension was associated with a higher age at onset of ALS and a shorter survival, and patients with a high CV risk profile had a worse prognosis than those with a low CV risk profile. The Cox multivariable analysis did not confirm such findings. Type 2 diabetes mellitus did not modify either the phenotype or the prognosis of ALS patients. This study performed on a large population-based cohort of ALS patients has demonstrated that arterial hypertension, type 2 diabetes and CV risk factors, calculated using the Framingham equation, do not influence ALS phenotype and prognosis.

  4. Pulmonary hypertension CT imaging

    Nedevska, A.

    2013-01-01

    Full text: The right heart catheterization is the gold standard in the diagnosis and determines the severity of pulmonary hypertension. The significant technical progress of noninvasive diagnostic imaging methods significantly improves the pixel density and spatial resolution in the study of cardiovascular structures, thus changes their role and place in the overall diagnostic plan. Learning points: What is the etiology, clinical manifestation and general pathophysiological disorders in pulmonary hypertension. What are the established diagnostic methods in the diagnosis and follow-up of patients with pulmonary hypertension. What is the recommended protocol for CT scanning for patients with clinically suspected or documented pulmonary hypertension. What are the important diagnostic findings in CT scan of a patient with pulmonary hypertension. Discussion: The prospect of instantaneous complex - anatomical and functional cardiopulmonary and vascular diagnostics seems extremely attractive. The contrast enhanced multislice computed (CT ) and magnetic resonance imaging are very suitable methods for imaging the structures of the right heart, with the possibility of obtaining multiple projections and three-dimensional imaging reconstructions . There are specific morphological features that, if carefully analyzed, provide diagnostic information. Thus, it is possible to avoid or at least reduce the frequency of use of invasive diagnostic cardiac catheterization in patients with pulmonary hypertension. Conclusion: This review focuses on the use of contrast-enhanced CT for comprehensive evaluation of patients with pulmonary hypertension and presents the observed characteristic changes in the chest, lung parenchyma , the structures of the right half of the heart and pulmonary vessels

  5. Association Between Awareness of Hypertension and Health-Related Quality of Life in a Cross-Sectional Population-Based Study in Rural Area of Northwest China.

    Mi, Baibing; Dang, Shaonong; Li, Qiang; Zhao, Yaling; Yang, Ruihai; Wang, Duolao; Yan, Hong

    2015-07-01

    Hypertensive patients have more complex health care needs and are more likely to have poorer health-related quality of life than normotensive people. The awareness of hypertension could be related to reduce health-related quality of life. We propose the use of quantile regression to explore more detailed relationships between awareness of hypertension and health-related quality of life. In a cross-sectional, population-based study, 2737 participants (including 1035 hypertensive patients and 1702 normotensive participants) completed the Short-Form Health Survey. A quantile regression model was employed to investigate the association of physical component summary scores and mental component summary scores with awareness of hypertension and to evaluate the associated factors. Patients who were aware of hypertension (N = 554) had lower scores than patients who were unaware of hypertension (N = 481). The median (IQR) of physical component summary scores: 48.20 (13.88) versus 53.27 (10.79), P mental component summary scores: 50.68 (15.09) versus 51.70 (10.65), P = 0.03. adjusting for covariates, the quantile regression results suggest awareness of hypertension was associated with most physical component summary scores quantiles (P mental component summary scores quantiles in which the β-estimates from -3.47 (95% CI: -6.65 to -0.39) to -2.18 (95% CI: -4.30 to -0.06). The awareness of hypertension has a greater effect on those with intermediate physical component summary status: the β-estimates were equal to -2.04 (95% CI: -3.51 to -0.57, P Awareness of hypertension was negatively related to health-related quality of life in hypertensive patients in rural western China, which has a greater effect on mental component summary scores with the poorer status and on physical component summary scores with the intermediate status.

  6. Can Pediatric Hypertension Criteria Be Simplified? A Prediction Analysis of Subclinical Cardiovascular Outcomes From the Bogalusa Heart Study.

    Xi, Bo; Zhang, Tao; Li, Shengxu; Harville, Emily; Bazzano, Lydia; He, Jiang; Chen, Wei

    2017-04-01

    Prehypertension and hypertension in childhood are defined by sex-, age-, and height-specific 90th (or ≥120/80 mm Hg) and 95th percentiles of blood pressure, respectively, by the 2004 Fourth Report. However, these cutoffs are complex and cumbersome for use. This study assessed the performance of a simplified blood pressure definition to predict adult hypertension and subclinical cardiovascular disease. The cohort consisted of 1225 adults (530 men; aged 26.3-47.7 years) from the Bogalusa Heart Study with 27.1-year follow-up since childhood. We used 110/70 and 120/80 mm Hg for children (age, 6-11 years), and 120/80 and 130/85 mm Hg for adolescents (age, 12-17 years) as the simplified definition of childhood prehypertension and hypertension, respectively, to compare with the 2004 Fourth Report (the complex definition). Adult carotid intima-media thickness, pulse wave velocity, and left ventricular mass were measured using digital ultrasound instruments. Compared with normal blood pressure, childhood hypertensives diagnosed by the simplified definition and the complex definition were both at higher risk of adult hypertension with hazard ratio of 3.1 (95% confidence interval, 1.8-5.3) by the simplified definition and 3.2 (2.0-5.0) by the complex definition, high pulse wave velocity with 3.5 (1.7-7.1) and 2.2 (1.2-4.1), high carotid intima-media thickness with 3.1 (1.7-5.6) and 2.0 (1.2-3.6), and left ventricular hypertrophy with 3.4 (1.7-6.8) and 3.0 (1.6-5.6). The results were confirmed by reclassification or receiver operating curve analyses. The simplified childhood blood pressure definition predicts the risk of adult hypertension and subclinical cardiovascular disease equally as the complex definition does, which could be useful for screening hypertensive children to reduce risk of adult cardiovascular disease. © 2017 American Heart Association, Inc.

  7. [Hypertension in polycystic ovary syndrome].

    Ben Salem Hachmi, L; Ben Salem Hachmi, S; Bouzid, C; Younsi, N; Smida, H; Bouguerra, R; Ben Slama, C

    2006-01-01

    Polycystic ovary syndrome (PCOS) is associated with multiple cardiovascular risk factors. The aims of this study are to investigate the prevalence of hypertension in a female population with PCOS and to correlate hypertension with her clinical and hormonal profile. it is a transversal study of 79 PCOS patients with mean age of 25 +/- 7 years (range 13-44). PCOS diagnosis is made by Rotterdam consensus criteria's (2003). WHO definition of hypertension is used (BP 140/90 mmHg). Blood pressure is measured three times in each patient. Ovarian echography and biochemical assays (GnRH test, androgens, cholesterol, triglycerides, and oral glucose tolerance test) are made before the 5th day of the menstrual cycle. 12% of PCOS women have hypertension. Family history of hypertension is not a predictive factor of hypertension in our study. PCOS patients with hypertension are not significantly older than those without hypertension (28.4 +/- 6.5 vs. 25.2 +/- 7; p = 0.12). If compared to PCOS women without hypertension, those with hypertension have a significantly higher BMI (39.2 +/- 7 vs. 29.6; p = 0.0004). PCOS patients with and without hypertension do not differ significantly in their level of androgens and total cholesterol. Triglycerides level is higher in PCOS patients with hypertension (p = 0.06). In oral glucose tolerance test, areas under the curve of insulin and glucose are significantly higher in PCOS patients with hypertension (respectively p = 0.06 and 0.02). The area under the curve of LH during GnRH test is lower in PCOS patients with hypertension (p = 0.04).

  8. Individualized prevention against hypertension based on Traditional Chinese Medicine Constitution Theory: A large community-based retrospective, STROBE-compliant study among Chinese population.

    Li, Ying; Li, Xiao-Hui; Huang, Xin; Yin, Lu; Guo, Cheng-Xian; Liu, Chang; He, Yong-Mei; Liu, Xing; Yuan, Hong

    2017-11-01

    Traditional Chinese Medicine Constitution (TCMC) theory states that individuals with a biased TCMC are more likely to suffer from specific diseases. However, little is known regarding the influence of TCMC on susceptibility to hypertension. The aim of this study is to examine the possible relationship between TCMC and hypertension. Retrospective evaluation and observation were performed using the STROBE guidelines checklist. A large community-based cross-sectional study was conducted between 2009 and 2013 in Changsha, China. TCMC was assessed using a questionnaire that included 68 items. TCMC distributions and the associations of different TCMCs with hypertension risk were analyzed. In total, 144,439 subjects underwent evaluations of TCMC and blood pressure (BP). There were significant differences in the hypertension prevalence among the various TCMC groups (P medicine criteria; for example, phlegm wetness with hypertension was similar to obesity-related hypertension. Our results suggest that phlegm wetness, yin deficiency, blood stasis, and qi deficiency have different effects on the prevalence of hypertension. More attention should be paid to TCMCs associated with susceptibility to hypertension, and corresponding preventive and therapeutic treatments should be developed according to different TCMCs.

  9. Utility of the physical examination in detecting pulmonary hypertension. A mixed methods study.

    Rebecca Colman

    Full Text Available INTRODUCTION: Patients with pulmonary hypertension (PH often present with a variety of physical findings reflecting a volume or pressure overloaded right ventricle (RV. However, there is no consensus regarding the diagnostic utility of the physical examination in PH. METHODS: We conducted a systematic review of publications that evaluated the clinical examination and diagnosis of PH using MEDLINE (1946-2013 and EMBASE (1947-2013. We also prospectively evaluated the diagnostic utility of the physical examination findings. Patients who underwent right cardiac catheterization for any reason were recruited. After informed consent, participants were examined by 6 physicians (3 "specialists" and 3 "generalists" who were unaware of the results of the patient's hemodynamics. Each examiner independently assessed patients for the presence of a RV lift, loud P2, jugular venous distension (JVD, tricuspid insufficiency murmur and right-sided 4th heart sound at rest and during a slow inspiration. A global rating (scale of 1-5 of the likelihood that the patient had pulmonary hypertension was provided by each examiner. RESULTS: 31 articles that assessed the physical examination in PH were included in the final analysis. There was heterogeneity amongst the studies and many did not include control data. The sign most associated with PH in the literature was a loud pulmonic component of the second heart sound (P2. In our prospective study physical examination was performed on 52 subjects (25 met criteria for PH; mPAP ≥ 25 mmHg. The physical sign with the highest likelihood ratio (LR was a loud P2 on inspiration with a LR +ve 1.9, 95% CrI [1.2, 3.1] when data from all examiners was analyzed together. Results from the specialist examiners had higher diagnostic utility; a loud P2 on inspiration was associated with a positive LR of 3.2, 95% CrI [1.5, 6.2] and a right sided S4 on inspiration had a LR +ve 4.7, 95% CI [1.0, 15.6]. No aspect of the physical exam, could

  10. Utility of the physical examination in detecting pulmonary hypertension. A mixed methods study.

    Colman, Rebecca; Whittingham, Heather; Tomlinson, George; Granton, John

    2014-01-01

    Patients with pulmonary hypertension (PH) often present with a variety of physical findings reflecting a volume or pressure overloaded right ventricle (RV). However, there is no consensus regarding the diagnostic utility of the physical examination in PH. We conducted a systematic review of publications that evaluated the clinical examination and diagnosis of PH using MEDLINE (1946-2013) and EMBASE (1947-2013). We also prospectively evaluated the diagnostic utility of the physical examination findings. Patients who underwent right cardiac catheterization for any reason were recruited. After informed consent, participants were examined by 6 physicians (3 "specialists" and 3 "generalists") who were unaware of the results of the patient's hemodynamics. Each examiner independently assessed patients for the presence of a RV lift, loud P2, jugular venous distension (JVD), tricuspid insufficiency murmur and right-sided 4th heart sound at rest and during a slow inspiration. A global rating (scale of 1-5) of the likelihood that the patient had pulmonary hypertension was provided by each examiner. 31 articles that assessed the physical examination in PH were included in the final analysis. There was heterogeneity amongst the studies and many did not include control data. The sign most associated with PH in the literature was a loud pulmonic component of the second heart sound (P2). In our prospective study physical examination was performed on 52 subjects (25 met criteria for PH; mPAP ≥ 25 mmHg). The physical sign with the highest likelihood ratio (LR) was a loud P2 on inspiration with a LR +ve 1.9, 95% CrI [1.2, 3.1] when data from all examiners was analyzed together. Results from the specialist examiners had higher diagnostic utility; a loud P2 on inspiration was associated with a positive LR of 3.2, 95% CrI [1.5, 6.2] and a right sided S4 on inspiration had a LR +ve 4.7, 95% CI [1.0, 15.6]. No aspect of the physical exam, could consistently rule out PH (negative LRs 0

  11. Utility of the Physical Examination in Detecting Pulmonary Hypertension. A Mixed Methods Study

    Colman, Rebecca; Whittingham, Heather; Tomlinson, George; Granton, John

    2014-01-01

    Introduction Patients with pulmonary hypertension (PH) often present with a variety of physical findings reflecting a volume or pressure overloaded right ventricle (RV). However, there is no consensus regarding the diagnostic utility of the physical examination in PH. Methods We conducted a systematic review of publications that evaluated the clinical examination and diagnosis of PH using MEDLINE (1946–2013) and EMBASE (1947–2013). We also prospectively evaluated the diagnostic utility of the physical examination findings. Patients who underwent right cardiac catheterization for any reason were recruited. After informed consent, participants were examined by 6 physicians (3 “specialists” and 3 “generalists”) who were unaware of the results of the patient's hemodynamics. Each examiner independently assessed patients for the presence of a RV lift, loud P2, jugular venous distension (JVD), tricuspid insufficiency murmur and right-sided 4th heart sound at rest and during a slow inspiration. A global rating (scale of 1–5) of the likelihood that the patient had pulmonary hypertension was provided by each examiner. Results 31 articles that assessed the physical examination in PH were included in the final analysis. There was heterogeneity amongst the studies and many did not include control data. The sign most associated with PH in the literature was a loud pulmonic component of the second heart sound (P2). In our prospective study physical examination was performed on 52 subjects (25 met criteria for PH; mPAP ≥25 mmHg). The physical sign with the highest likelihood ratio (LR) was a loud P2 on inspiration with a LR +ve 1.9, 95% CrI [1.2, 3.1] when data from all examiners was analyzed together. Results from the specialist examiners had higher diagnostic utility; a loud P2 on inspiration was associated with a positive LR of 3.2, 95% CrI [1.5, 6.2] and a right sided S4 on inspiration had a LR +ve 4.7, 95% CI [1.0, 15.6]. No aspect of the physical exam, could

  12. Race and perceived racism, education, and hypertension among Brazilian civil servants: the Pró-Saúde Study

    Eduardo Faerstein

    2014-01-01

    Full Text Available INTRODUCTION: Brazil has the largest population of African descendants outside Africa. OBJECTIVE: Mindful of the imprint of slavery on their contemporary social position, we investigated the relationship of perceived racism to hypertension. METHODS: We analyzed data (1999 - 2001 from 3,056 civil servants (mean age 42 years; 56% females at university campuses in Rio participating in the longitudinal Pró-Saúde Study. RESULTS: Cases of prevalent hypertension had measured blood pressure equal to or greater than 140/90 mmHg or used antihypertensive medication. Self-administered questionnaires assessed participants' perceived history of lifetime discrimination (due to race, gender, socioeconomic position, and other attributes at work and school, neighborhood, public places, and in contact with the police. Participants used 41 terms as responses to an open-ended question on racial self-identification; for these analyses, 48% were classified as afrodescendants. Racial discrimination in at least one setting was reported by 14% of afrodescendants. Compared to whites, the age- and gender-adjusted prevalence of hypertension was higher for afrodescendants with history of self-perceived racism (prevalence ratio - PR = 2.1; 95%CI 1.5 - 3.0 than for those with no such history (PR = 1.5; 95%CI 1.2 - 1.8. Comparing the former to whites, the adjusted association with hypertension was stronger for those with elementary education (PR = 3.0; 95%CI 1.3 - 6.7 than for those with a college degree (PR = 1.7; 95%CI 1.0 - 3.1. CONCLUSION: Racism may increase the risk of hypertension of afrodescendants in Brazil, and socioeconomic disadvantage - also influenced by societal racism - may further potentiate this increased risk.

  13. Salinity in drinking water and the risk of (preeclampsia and gestational hypertension in coastal Bangladesh: a case-control study.

    Aneire Ehmar Khan

    Full Text Available BACKGROUND: Hypertensive disorders in pregnancy are among the leading causes of maternal and perinatal death in low-income countries, but the aetiology remains unclear. We investigated the relationship between salinity in drinking water and the risk of (preeclampsia and gestational hypertension in a coastal community. METHODS: A population-based case-control study was conducted in Dacope, Bangladesh among 202 pregnant women with (preeclampsia or gestational hypertension, enrolled from the community served by the Upazilla Health Complex, Dacope and 1,006 matched controls from the same area. Epidemiological and clinical data were obtained from all participants. Urinary sodium and sodium levels in drinking water were measured. Logistic regression was used to calculate odds ratios, and 95% confidence intervals. FINDINGS: Drinking water sources had exceptionally high sodium levels (mean 516.6 mg/L, S.D 524.2. Women consuming tube-well (groundwater were at a higher disease risk than rainwater users (p900.01 mg/L, compared to <300 mg/L in drinking water (ORs 3.30 [95% CI 2.00-5.51], 4.40 [2.70-7.25] and 5.48 [3.30-9.11] (p-trend<0.001. Significant associations were seen for both (preeclampsia and gestational hypertension separately. INTERPRETATION: Salinity in drinking water is associated with increased risk of (preeclampsia and gestational hypertension in this population. Given that coastal populations in countries such as Bangladesh are confronted with high salinity exposure, which is predicted to further increase as a result of sea level rise and other environmental influences, it is imperative to develop and evaluate affordable approaches to providing water with low salt content.

  14. Race and perceived racism, education, and hypertension among Brazilian civil servants: the Pró-Saúde Study.

    Faerstein, Eduardo; Chor, Dóra; Werneck, Guilherme Loureiro; Lopes, Claudia de Souza; Kaplan, George

    2014-01-01

    Brazil has the largest population of African descendants outside Africa. Mindful of the imprint of slavery on their contemporary social position, we investigated the relationship of perceived racism to hypertension. We analyzed data (1999 - 2001) from 3,056 civil servants (mean age 42 years; 56% females) at university campuses in Rio participating in the longitudinal Pró-Saúde Study. Cases of prevalent hypertension had measured blood pressure equal to or greater than 140/90 mmHg or used antihypertensive medication. Self-administered questionnaires assessed participants' perceived history of lifetime discrimination (due to race, gender, socioeconomic position, and other attributes) at work and school, neighborhood, public places, and in contact with the police. Participants used 41 terms as responses to an open-ended question on racial self-identification; for these analyses, 48% were classified as afrodescendants. Racial discrimination in at least one setting was reported by 14% of afrodescendants. Compared to whites, the age- and gender-adjusted prevalence of hypertension was higher for afrodescendants with history of self-perceived racism (prevalence ratio--PR = 2.1; 95%CI 1.5-3.0) than for those with no such history (PR = 1.5; 95%CI 1.2-1.8). Comparing the former to whites, the adjusted association with hypertension was stronger for those with elementary education (PR = 3.0; 95%CI 1.3-6.7) than for those with a college degree (PR = 1.7; 95%CI 1.0-3.1). Racism may increase the risk of hypertension of afrodescendants in Brazil, and socioeconomic disadvantage--also influenced by societal racism--may further potentiate this increased risk.

  15. Correlation of serum paraoxonase activities in known cases of 130 elderly hypertensive South Asian aged 56-64 years - a hospital based study

    Arun Kumar

    2014-02-01

    Full Text Available Objective: To evaluate paraoxonase activity, antioxidant status and lipid peroxidation in hypertensive participants and to address the hypothesis that oxidative modifications of lipids due to hypertension can cause changes in serum paraoxonase activities. Methods: The serum paraoxonase activities, antioxidants and lipid peroxidation were determined in 130 hypertensive participants and 130 age-sexes matched normotensive healthy volunteers served as control. Serum paraoxonase activities were measured by enzymatic kit. The glutathione peroxidase, superoxide dismutase and catalase activity were determined by standard methods. Malondialdehyde was measured by thiobarbituric acid reaction. Conjugated diene level was measured by Recknagel and Glende method. Serum uric acid, total bilirubin, serum albumin, serum ascorbic acid and lipid profile were analyzed by standard methods. Results: Total cholesterol, triglycerides, low-density lipoprotein cholesterol were significantly higher and high-density lipoprotein cholesterol were significantly lower in hypertensive patients when compared to normotensive healthy controls. The superoxide dismutase, glutathione peroxidase and catalase were significantly lower in hypertensive when compared with normotensive. Similar findings were observed in the levels of albumin, uric acid, bilirubin and ascorbic acid when hypertensives were compared with normotensive. The oxidative stress indicators namely malondialdehyde and conjugated diene were significantly higher and paraoxonase activity were significantly lower in hypertensive. Conclusions: Our study concludes that paraoxonase activities are bound to alter in hypertension which is caused due to interplay of several confounding factors namely oxidative stress, increased oxidized low-density lipoprotein and depletion of antioxidants.

  16. Prevalence and control of hypertension among a Community of Elderly Population in Changning District of shanghai: a cross-sectional study.

    Yang, Zhi-Qi; Zhao, Qi; Jiang, Ping; Zheng, Song-Bai; Xu, Biao

    2017-12-28

    Hypertension is considered a major public health challenge. It is the most important risk factor for cardiovascular disease and is a prominent risk for China's elderly population. However, few studies have addressed the effect of blood pressure control on elderly hypertension patients in China. In response, this study aimed to investigate the prevalence and control of hypertension in the elderly population in Shanghai's communities. A secondary data analysis based on a government-financed health check-up program for an elderly population aged 65 and older from 2012 to 2014 was conducted in a central district of Shanghai. Of the 44,978 study participants, 20,305 (45.1%) were males and 24,673 (54.9%) were females. The participants' median age was 72. Half of the participants were overweight or obese (BMI ≥ 24.0 kg/m 2 ). The prevalence of hypertension was 59.9%. In the 18,032 participants without prior diagnosis of hypertension, 5530 (30.7%) had increased blood pressure. Among the 26,946 confirmed hypertension patients, the proportions of treatment and blood pressure control were 32.8% and 43.4% respectively. Multivariate analysis showed that the uncontrolled hypertension was significantly associated with older age, being overweight or obese, a lower level of education, an unbalanced dietary pattern, regular drinking and non-comorbidities. The prevalence of hypertension was high in China's elderly population. The proportion of individuals who received treatment remained low, and blood pressure control was poor among hypertension patients. These results indicate that improvement of the ability to manage and control hypertension among urban elderly residents is urgently needed.

  17. Cervical Spondylosis and Hypertension

    Peng, Baogan; Pang, Xiaodong; Li, Duanming; Yang, Hong

    2015-01-01

    Abstract Cervical spondylosis and hypertension are all common diseases, but the relationship between them has never been studied. Patients with cervical spondylosis are often accompanied with vertigo. Anterior cervical discectomy and fusion is an effective method of treatment for cervical spondylosis with cervical vertigo that is unresponsive to conservative therapy. We report 2 patients of cervical spondylosis with concomitant cervical vertigo and hypertension who were treated successfully w...

  18. Hypertension screening

    Foulke, J. M.

    1975-01-01

    An attempt was made to measure the response to an announcement of hypertension screening at the Goddard Space Center, to compare the results to those of previous statistics. Education and patient awareness of the problem were stressed.

  19. Transition from Ambrisentan to Bosentan in Pulmonary Arterial Hypertension: A Single-Center Prospective Study

    Su-Gang Gong

    2018-01-01

    Full Text Available Background and objective: Two endothelin receptor antagonists (ETRAs, bosentan and ambrisentan, are approved for patients with pulmonary arterial hypertension (PAH. However, there is little information about the transition strategy between these two ETRAs. We aimed to evaluate the safety and efficacy from ambrisentan to bosentan. Methods: Twenty PAH patients were enrolled into the single-center, open-labelled prospective study. Echocardiogram, WHO functional class (WHO-FC, 6-minute walking distance (6MWD, right heart catheterization, and hemotology were collected. After receiving oral 5 mg ambrisentan daily initially for one year, the patients were divided into two arms: eight patients switched to bosentan, while the remaining 12 patients continued ambrisentan. Characteristics at baseline, 1-and 2-year follow-up points were compared. Results: There were no significant differences in echocardiogram, WHO-FC, hemodynamics, demographics and liver function at baseline, 1-and 2-year points in both arms. 6MWD in bosentan group was significantly shorter at baseline. But there were no significant differences of 6MWD at 1- and 2-year points. Conclusions: It is safe for stable PAH patients to transition from ambrisentan to bosentan without hemodynamic or hematologic deterioration.

  20. Furosemide versus Hydralazine for Managing Post Partum Hypertension in Severe Preeclampsia: A Comparative Study

    M Behrashi

    2012-10-01

    Full Text Available Introduction: Gestational hypertension and preeclampsia are important maternal and fetal– infant complications and they can be regarded as the second cause of maternal death as well. The present study aimed to assess the effects of hydralazine and furosemide on blood pressure in sever preeclampsia. Methods: One hundred patients with severe preeclampsia were enrolled. After spontaneous onset of postpartum diuresis and discontinuation of intravenous magnesium sulfate, patients were randomly assigned to receive either Hydralazine10mg QID or furosemide10mg BID for 5 days. Patients’ blood pressure was recorded every 6h and the collected data were compared. Results: Postpartum patients with severe preeclampsia who received furosemide had significantly lower systolic blood pressure by postpartum fifth day(66% compared with 42%, P=0.016;OR=2.6 compared to those who had hydralazine. On the other hand, the time duration of response to treatment was lower in patients who received hydralazine compared with furosemide (24.3h compared with 31.4h; P=0.034. Conclusion: Furosemide proved to be more effective on blood pressure mean reduction compared with Hydralazine in women with sever preeclampsia.

  1. [Pulmonary arterial hypertension associated with human immunodeficiency virus infection: study of 4 cases].

    Pousada, Guillermo; Baloira, Adolfo; Castro-Añón, Olalla; Valverde, Diana

    2016-04-15

    Pulmonary arterial hypertension (PAH) is a rare and progressive disease that can be inherited as autosomal dominant form. The BMPR2, ACVRL1 and ENG genes are main genes involved in the pathology. PAH associated to human immunodeficiency virus (HIV) is another rare disease with a low incidence, prevalence and survival. The main objective of this analysis was to study the clinical and molecular characteristics of PAH associated to HIV patients. We present 4 cases of HIV patients who developed PAH and have been treated with ambrisentan. Pathogenic mutations have been identify in analyzed genes in 3 of the four analyzed patients. In addition, these patients present other changes classified as benign after a thorough in silico analysis. We identified some changes in genetic modifiers that predispose to these patients to more severe phenotype. The clinical analysis can help to define monitoring for these patients and the administration of appropriate treatment. These patients also have shown several pathogenic mutations. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  2. Predictive models to assess risk of type 2 diabetes, hypertension and comorbidity: machine-learning algorithms and validation using national health data from Kuwait--a cohort study.

    Farran, Bassam; Channanath, Arshad Mohamed; Behbehani, Kazem; Thanaraj, Thangavel Alphonse

    2013-05-14

    We build classification models and risk assessment tools for diabetes, hypertension and comorbidity using machine-learning algorithms on data from Kuwait. We model the increased proneness in diabetic patients to develop hypertension and vice versa. We ascertain the importance of ethnicity (and natives vs expatriate migrants) and of using regional data in risk assessment. Retrospective cohort study. Four machine-learning techniques were used: logistic regression, k-nearest neighbours (k-NN), multifactor dimensionality reduction and support vector machines. The study uses fivefold cross validation to obtain generalisation accuracies and errors. Kuwait Health Network (KHN) that integrates data from primary health centres and hospitals in Kuwait. 270 172 hospital visitors (of which, 89 858 are diabetic, 58 745 hypertensive and 30 522 comorbid) comprising Kuwaiti natives, Asian and Arab expatriates. Incident type 2 diabetes, hypertension and comorbidity. Classification accuracies of >85% (for diabetes) and >90% (for hypertension) are achieved using only simple non-laboratory-based parameters. Risk assessment tools based on k-NN classification models are able to assign 'high' risk to 75% of diabetic patients and to 94% of hypertensive patients. Only 5% of diabetic patients are seen assigned 'low' risk. Asian-specific models and assessments perform even better. Pathological conditions of diabetes in the general population or in hypertensive population and those of hypertension are modelled. Two-stage aggregate classification models and risk assessment tools, built combining both the component models on diabetes (or on hypertension), perform better than individual models. Data on diabetes, hypertension and comorbidity from the cosmopolitan State of Kuwait are available for the first time. This enabled us to apply four different case-control models to assess risks. These tools aid in the preliminary non-intrusive assessment of the population. Ethnicity is seen significant

  3. Endokrin hypertension

    Poulsen, Per Løgstrup; Ibsen, Hans

    2009-01-01

    Endocrine hypertension is rare, but frequently refractory. Adenomas are common incidental findings. Biochemical tests confirm the diagnosis. Primary aldosteronism is the most common form. Hypokalaemia is an important sign, but 50% of patients may be normokalaemic. The plasma-aldosterone-to-renin ......Endocrine hypertension is rare, but frequently refractory. Adenomas are common incidental findings. Biochemical tests confirm the diagnosis. Primary aldosteronism is the most common form. Hypokalaemia is an important sign, but 50% of patients may be normokalaemic. The plasma...

  4. Resistant hypertension.

    Wei, Fang-Fei; Zhang, Zhen-Yu; Huang, Qi-Fang; Yang, Wen-Yi; Staessen, Jan A

    2018-06-15

    The publication of the first non-randomised proof-of-concept trial of renal denervation as a treatment modality in treatment-resistant hypertension set the stage for a search for novel devices with the expectation that technology would reduce the burden of hypertension by reducing or eliminating the costly and lifelong use of blood pressure lowering medications. As we demonstrate in this review, this idea so attractive to manufacturers and invasive cardiologists and radiologists overlooked decades of careful pathophysiological research in a disease, which still remains enigmatic but remains the major cause of cardiovascular mortality worldwide. To make our point, we first reviewed the prevalence and risks associated with treatment-resistant hypertension. Next, we highlighted the key points required for the diagnosis of treatment-resistant hypertension, including the recording of the ambulatory blood pressure and the assessment of adherence to medication. Finally, we summarised new insights in the management of treatment-resistant hypertension by medication and devices and in the future research. Throughout our review, we focused on new evidence became available since 2013. Our conclusion is that optimising medical treatment based on simple algorithms remains the state of the art in treatment-resistant hypertension.

  5. Toward Hypertension Prediction Based on PPG-Derived HRV Signals: a Feasibility Study.

    Lan, Kun-Chan; Raknim, Paweeya; Kao, Wei-Fong; Huang, Jyh-How

    2018-04-21

    Heart rate variability (HRV) is often used to assess the risk of cardiovascular disease, and data on this can be obtained via electrocardiography (ECG). However, collecting heart rate data via photoplethysmography (PPG) is now a lot easier. We investigate the feasibility of using the PPG-based heart rate to estimate HRV and predict diseases. We obtain three months of PPG-based heart rate data from subjects with and without hypertension, and calculate the HRV based on various forms of time and frequency domain analysis. We then apply a data mining technique to this estimated HRV data, to see if it is possible to correctly identify patients with hypertension. We use six HRV parameters to predict hypertension, and find SDNN has the best predictive power. We show that early disease prediction is possible through collecting one's PPG-based heart rate information.

  6. Left atrial systolic force in hypertensive patients with left ventricular hypertrophy: the LIFE study

    Chinali, M.; Simone, G. de; Wachtell, K.

    2008-01-01

    In hypertensive patients without prevalent cardiovascular disease, enhanced left atrial systolic force is associated with left ventricular hypertrophy and increased preload. It also predicts cardiovascular events in a population with high prevalence of obesity. Relations between left atrial...... systolic force and left ventricular geometry and function have not been investigated in high-risk hypertrophic hypertensive patients. Participants in the Losartan Intervention For Endpoint reduction in hypertension echocardiography substudy without prevalent cardiovascular disease or atrial fibrillation (n...... = 567) underwent standard Doppler echocardiography. Left atrial systolic force was obtained from the mitral orifice area and Doppler mitral peak A velocity. Patients were divided into groups with normal or increased left atrial systolic force (>14.33 kdyn). Left atrial systolic force was high in 297...

  7. A clinical study of thallium-201 scintigraphy in hypertensive patients with and without left ventricular hypertrophy

    Ouyang Wei; He Guorong; Liu Jinhua; Huang Yuying; Qian Xuexian

    2001-01-01

    Objective: Based on coronary angiography, thallium-201 myocardial scintigraphy was evaluated in hypertensive patients with and without left ventricular hypertrophy, and the causes of its perfusion abnormalities were discussed. Methods: Thallium-201 myocardial scintigraphy was performed on 85 patients with clinically suspected coronary artery disease. Coronary angiography was performed on patients with perfusion abnormalities in one month after scintigraphy. Results: The rate of 201 Tl perfusion abnormalities in hypertensive patients with hypertrophy (85.7%) was higher than normal blood pressure (39.3%, P 201 Tl perfusion abnormalities occur in hypertensive patients with hypertrophy. The perfusion abnormalities may be caused not only by coronary large vessel disease, but also by coronary microvascular disease

  8. Nutritional intake, depressive symptoms and vitamin D status in hypertensive patients in the north of Iran: A case-control study.

    Salari, A; Mahdavi-Roshan, M; Hasandokht, T; Gholipour, M; Soltanipour, S; Nagshbandi, M; Javadzadeh, A

    We investigated vitamin D status, body size, nutritional intake and depression status in hypertensive patients in the north of Iran that have special dietary habit and lifestyle according to their culture and geographical situation. This study was conducted on 127 patients with newly recognized hypertension and the 120 normal participants, in the north of Iran. Anthropometric data was measured and demographic characteristics, dietary intake, depression and medical status were collected by valid questionnaires. Blood samples were measured for 25-hydroxyvitamin D. Hypertensive patients had significantly lower serum 25-hydroxyvitamin D than control group (16±8.7ng/mL vs. 19.8±8.4ng/mL; P=0.04). In adjusted model, serum 25-hydroxyvitamin D of less than 30ng/mL was associated with an almost 4-fold odds of hypertension. The odds of hypertension in depressed patients was 1.2 times higher than in those without depression (p=0.002). After adjusted logistic regression analysis for energy intake, significant association was observed between hypertension and some dietary nutrients, including cholesterol, fiber and vitamin D intake. There was no significant association between hypertension and body weight, waist circumference as well as BMI. The vitamin D status was lower in the most individuals and it causes a considerable increase in the risk of hypertension. Undesirable intake of some nutrients and depression also increase the risk of developing hypertension. Health training about suitable dietary habits, easier access to vitamin D supplementation and screening for depression in patients with hypertension are cost-effective tools to improve outcomes in Iran. Copyright © 2016 SEH-LELHA. Publicado por Elsevier España, S.L.U. All rights reserved.

  9. Preeclampsia and gestational hypertension are associated with childhood blood pressure independently of family adiposity measures: the Avon Longitudinal Study of Parents and Children.

    Geelhoed, J J Miranda; Fraser, Abigail; Tilling, Kate; Benfield, Li; Davey Smith, George; Sattar, Naveed; Nelson, Scott M; Lawlor, Debbie A

    2010-09-21

    Offspring of women with hypertensive disorders of pregnancy are at increased risk of cardiovascular complications later in life, but the mechanisms underlying these associations are unclear. Our aim was to examine whether adjusting for birth weight and familial adiposity changed the association of hypertensive disorders of pregnancy with offspring blood pressure. Using data from 6343 nine-year-old participants in the Avon Longitudinal Study of Parents and Children, we examined the association between hypertensive disorders of pregnancy (preeclampsia and gestational hypertension) and offspring blood pressure. Both preeclampsia and gestational hypertension were associated with systolic and diastolic blood pressures in the 9-year-old offspring; after adjustment for parental and own adiposity and for other potential confounders, the mean difference in systolic blood pressure was 2.05 mm Hg (95 confidence interval, 0.72 to 3.38) and 2.04 mm Hg (95 confidence interval, 1.42 to 2.67) for preeclampsia and gestational hypertension, respectively, compared with those with no hypertensive disorders of pregnancy. Equivalent results for diastolic blood pressure were 1.00 mm Hg (95 confidence interval, -0.01 to 2.10) and 1.07 mm Hg (95 confidence interval, 0.60 to 1.54). The association of preeclampsia with offspring systolic and diastolic blood pressures attenuated toward the null with further adjustment for birth weight and gestational age, whereas these adjustments did not attenuate the association of gestational hypertension with offspring blood pressure. The associations of hypertensive disorders of pregnancy with higher offspring blood pressure are not explained by familial adiposity. The mechanisms linking preeclampsia and gestational hypertension with offspring blood pressure may differ, with the former mediated at least in part by the effect of preeclampsia on intrauterine growth restriction.

  10. Correlations of urinary cadmium with hypertension and diabetes in persons living in cadmium-contaminated villages in northwestern Thailand: A population study

    Swaddiwudhipong, Witaya, E-mail: swaddi@hotmail.com [Department of Community and Social Medicine, Mae Sot General Hospital, Tak 63110 (Thailand); Mahasakpan, Pranee [Department of Community and Social Medicine, Mae Sot General Hospital, Tak 63110 (Thailand); Limpatanachote, Pisit; Krintratun, Somyot [Department of Internal Medicine, Mae Sot General Hospital, Tak (Thailand)

    2010-08-15

    Risk for hypertension and diabetes has not been conclusively found to be a result of cadmium exposure. A population-based study was conducted in 2009 to examine the correlations of urinary cadmium, a good biomarker of long-term cadmium exposure, with hypertension and diabetes in persons aged 35 years and older who lived in the 12 cadmium-contaminated rural villages in northwestern Thailand. A total of 5273 persons were interviewed and screened for urinary cadmium, hypertension, and diabetes. The geometric mean level of urinary cadmium for women (2.4{+-}2.3 {mu}g/g creatinine) was significantly greater than that for men (2.0{+-}2.2 {mu}g/g creatinine). Hypertension was presented in 29.8% of the study population and diabetes was detected in 6.6%. The prevalence of hypertension significantly increased from 25.0% among persons in the lowest tertile of urinary cadmium to 35.0% in the highest tertile. In women, the rate of hypertension significantly increased with increasing urinary cadmium levels in both ever and never smokers, after adjusting for age, alcohol consumption, body mass index, and diabetes. In men, such association was less significantly found in never smokers. The study revealed no significant association between urinary cadmium and diabetes in either gender. Our study supports the hypothesis that environmental exposure to cadmium may increase the risk of hypertension. Risk for diabetes in relation to cadmium exposure remains uncertain in this exposed population.

  11. Correlations of urinary cadmium with hypertension and diabetes in persons living in cadmium-contaminated villages in northwestern Thailand: A population study

    Swaddiwudhipong, Witaya; Mahasakpan, Pranee; Limpatanachote, Pisit; Krintratun, Somyot

    2010-01-01

    Risk for hypertension and diabetes has not been conclusively found to be a result of cadmium exposure. A population-based study was conducted in 2009 to examine the correlations of urinary cadmium, a good biomarker of long-term cadmium exposure, with hypertension and diabetes in persons aged 35 years and older who lived in the 12 cadmium-contaminated rural villages in northwestern Thailand. A total of 5273 persons were interviewed and screened for urinary cadmium, hypertension, and diabetes. The geometric mean level of urinary cadmium for women (2.4±2.3 μg/g creatinine) was significantly greater than that for men (2.0±2.2 μg/g creatinine). Hypertension was presented in 29.8% of the study population and diabetes was detected in 6.6%. The prevalence of hypertension significantly increased from 25.0% among persons in the lowest tertile of urinary cadmium to 35.0% in the highest tertile. In women, the rate of hypertension significantly increased with increasing urinary cadmium levels in both ever and never smokers, after adjusting for age, alcohol consumption, body mass index, and diabetes. In men, such association was less significantly found in never smokers. The study revealed no significant association between urinary cadmium and diabetes in either gender. Our study supports the hypothesis that environmental exposure to cadmium may increase the risk of hypertension. Risk for diabetes in relation to cadmium exposure remains uncertain in this exposed population.

  12. Postmarketing study of efficacy and safety of losartan during the treatment of patients with mild and moderate hypertension: Lothar study

    Vasiljević Zorana

    2013-01-01

    Full Text Available Introduction. Losartan, the angiotensin type 1 receptor blocker (ARB exercises its main antihypertensive effect by vasodilatation of peripheral arteries. Objective. The aim of this study was to evaluate the antihypertensive effect and safety of losartan in patients with mild and moderate arterial hypertension (AH. Methods. This was an open post-marketing study with losartan as monotherapy in previously treated or untreated patients with AH. Primary efficacy parameter was the percentage of patients that achieved target blood pressure after 8-week treatment with a single daily dose of losartan of 50-100 mg. Safety parameters were assessed according to the percentage of adverse events and metabolic effects of therapy. Results. The study included 550 patients with AH (59% female and 41% male, mean age 56.8±11.4 years, BMI=27±4 kg/m2. Losartan was applied in 31% of untreated and 69% of previously treatment-resistant patients After 8 weeks target blood pressure was achieved in 67.8% (SBP and in 81.1% (DBP of patients, respectively. The mean decrease was 21.8% for SBP and 21.1% for DBP (p<0.001. Out of all, 65% of patients achieved both target SBP and DBP values. Hydrochlorothiazide was added to the therapy in 11.6% of patients. There were no significant differences in drug efficacy between the entire group and subgroups of patients with diabetes mellitus and impaired renal function (p=ns. Adverse events were rare and metabolic effect was favorable. Conclusion. Monotherapy with losartan in a dosage of 50-100 mg applied during 8 weeks resulted in achieving target values of blood pressure in 65% of patient with mild and moderate hypertension, also including the patients with diabetes mellitus and impaired renal function. Losartan is a safe and metabolically neutral medication.

  13. Knowledge regarding the prevention of chronic kidney disease in hypertensive and diabetic patients: a cross-sectional study

    Moura, Elaine Cristina Santa Cruz de; Barbosa, Jefferson Belarmino Nunes; Marinho, Patrícia Érika de Melo

    2017-01-01

    Abstract Introduction: Hypertension (HT) and diabetes mellitus (DM) lead to functional and structural changes in target organs such as the kidneys, characterizing the need for preventive actions to avoid Chronic Kidney Disease (CKD). Objective: To verify cardiologists’ and endocrinologists’ knowledge, indications and practices regarding prevention of CKD in patients with HT and DM. Methods: A cross-sectional study with 14 cardiologists and 5 endocrinologists applying a questionnaire about ...

  14. [Management of hypertension and diabetes in Primary Care clinical practice: ATENCION study].

    Millán Núñez-Cortés, J; de la Figuera von Wichmann, M; Rodríguez de Miguel, M; Orera Peña, M L; Labrador Barba, E; Lería Gelabert, M

    2017-04-01

    Cardiovascular diseases are the main cause of death in the Spanish population. The detection and control of cardiovascular risk factors are fundamental in the prevention of cardiovascular disease. The main objectives of this study are to analyse the attitudes and therapeutic decisions of Primary Care (PC) physicians when treating hypertension (HT) and diabetes mellitus type 2 (DM2), with the aim of establishing the situation and eventually proposing improvement strategies. A national ecological, multicentre, cross-sectional, and descriptive study was conducted in 2013. A questionnaire was used and 1,028 PC physicians took part in the study. A total of 92.9% of the investigators consulted have indicated that they follow the guidelines for evaluation, treatment, and diagnosis of HT, and 91.4% in the case of diabetes. The latter is diagnosed as a casual finding, while HT is diagnosed through active investigation in patients with other risk factors. Combined therapy takes more than 6 months to take effect in patients with HT, and between 8 and 9 months in diabetic patients. The percentage of non-compliance is similar (10-40%) in both pathologies. Around half the physicians questioned considered interaction with the specialist to be good or excellent (46% HT and 57.3% DM2). Clinical practices in PC for HT and DM2 have some basic criteria in common. The interaction with the specialist is good, but there is a considerable margin for improvement. Copyright © 2016 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  15. Systemic sclerosis patients with and without pulmonary arterial hypertension: a nailfold capillaroscopy study.

    Riccieri, Valeria; Vasile, Massimiliano; Iannace, Nicoletta; Stefanantoni, Katia; Sciarra, Iliana; Vizza, Carmine D; Badagliacca, Roberto; Poscia, Roberto; Papa, Silvia; Mezzapesa, Mario; Nocioni, Martina; Valesini, Guido

    2013-08-01

    Pulmonary arterial hypertension (PAH) is a complication of SSc due to increased vascular resistance, and abnormal vascularity is a well-known feature of the disease as shown by nailfold videocapillaroscopy (NVC). This study investigated for specific NVC changes in SSc patients with and without PAH to assess any useful difference. Twenty-four SSc patients, 12 with PAH and 12 without, entered the study. Evidence of PAH was defined as increased systolic pulmonary artery pressure (PAP) (≥35 mmHg), indirectly assessed by echocardiography and confirmed by right heart catheterization (mPAP > 25 mmHg). NVC was performed, and a semi-quantitative rating scale, a rating system for avascular areas and a specific NVC pattern evaluation, namely early, active and late, were used. An NVC score >1 was more frequently found in patients with PAH than those without, 11 cases (92%) vs 5 cases (42%) (P = 0.03); an avascular areas grade >1 was present in 10 (83%) and 2 (17%) cases, respectively (P = 0.003); and a more severe NC pattern (active/late) was described in 11 (92%) and 5 (42%) patients, respectively (P = 0.03). When we compared the mPAP with NVC parameters, we found significant correlations between mPAP values and the NVC score (P < 0.005) and with the avascular areas score (P < 0.001). Our results underline the relevance of early microvascular assessment in patients at risk of developing a severe complication such as PAH that can amplify the systemic microvascular impairment in SSc. More severe NVC abnormalities should lead to strict cardiopulmonary surveillance and a complete NVC study is indicated.

  16. Prognostic implications of ischemia modified albumin in known cases of86 elderly hypertensive South Asian aged 56-64 years - a hospital based study

    Arun Kumar

    2014-02-01

    Full Text Available Objective: To study associated ischemia modified albumin in hypertensive participants and to compare the results with normotensive healthy controls. Methods: A total of 86 hypertensive patients and 86 age-sex matched normotensive healthy volunteers were selected for this study. The study was conducted for a period of 3 years from September 2007 to August 2010. Biochemical parameters and other parameters such as smoking habits, systolic and diastolic blood pressure and family history were recorded. Lipid profile, ischemia modified albumin, malondialdehyde and conjugated diene were measured by standard methods and results were compared between patients and controls. Results: Total cholesterol, triglycerides, low density lipoprotein cholesterol were significantly higher (P<0.001 in hypertensive subjects when compared to normotensive control. Also, significant differences were seen in high density lipoprotein cholesterol levels between both groups (P<0.001 . The index of lipid per oxidation comprising both malondialdehyde and conjugated dienes were significantly higher in hypertensive compared to normotensive controls. Ischemia modified albumin levels were significantly increased among hypertensive compared to normotensive controls (P<0.001. Conclusions: Hypertensive patients have increased oxidative stress and are accompanied with rise in ischemia modified albumin. Ischemia modified albumin could be incorporated as a diagnostic test parameter in hypertensive to avoid the future acute coronary complications.

  17. Home based telemedicine intervention for patients with uncontrolled hypertension: - a real life - non-randomized study

    2014-01-01

    Background Control of blood pressure is frequently inadequate in spite of availability of several classes of well tolerated and effective antihypertensive drugs. Several factors, including the use of suboptimal doses of drugs, inadequate or ineffective treatments and poor drug compliance may be the reason for this phenomenon. The aim of the current non- randomized study was to evaluate the effectiveness of a Home-Based Telemedicine service in patients with uncontrolled hypertension. Methods 74 patients were enrolled in a Home Based Telemedicine group and 94 patients in the Usual Care group. At baseline and at the end of the study, patients in both groups were seen in a cardiology office. Patients in Home Based Telemedicine group additionally were followed by a physician-nurse, through scheduled and unscheduled telephone appointments. These patients also received a blood pressure measuring device that could transmit the readings to a central data monitor via secure data connection. Results During the study period (80 ± 25 days), a total of 17401 blood pressure measurements were taken in the Home Based Telemedicine group corresponding to 236 ± 136 readings per patient and a mean daily measurement of 3 ± 1.7. The scheduled telephone contacts (initiated by the nurse) equaled to 5.2 ± 4.3/patient (370 in total) and the unscheduled telephone contacts (initiated by the patients) were 0.4 ± 0.9/patient (30 in total). The mean systolic blood pressure values decreased from 153 ± 19 mmHg to 130 ± 15 mmHg (p < 0.0001) at the end of the study and diastolic blood pressure values decreased from 89 ± 10 mmHg to 76 ± 11 mmHg (p < 0.0001). In the Usual Care group, the mean systolic blood pressure values decreased from 156 ± 16 mmHg to 149 ± 17 mmHg (p < 0.05) at the end of the study and diastolic blood pressure values decreased from 90 ± 8 mmHg to 86 ± 9 mmHg (p < 0.05). The changes in drug

  18. Importance of a history of hypertension for the prognosis after acute myocardial infarction--for the Bucindolol Evaluation in Acute myocardial infarction Trial (BEAT) study group

    Ali, Irma; Akman, Dilek; Bruun, Niels Eske

    2004-01-01

    1999 with an enzyme-verified MI to 33 Danish coronary care units. Hypertension was considered present when a previous diagnosis of hypertension was accompanied by relevant medical therapy. Survival information for all patients was obtained in January 2002. RESULTS: Of the 3,326 patients studied, 825.......9-1.2, p = 0.6). Adjustment for further covariates did not change the result. CONCLUSION: Our study showed that after an acute MI the survival rate of patients with and without a history of hypertension was identical when they received contemporary medical therapy....

  19. Pregnancy-Induced Hypertensive Disorders before and after a National Economic Collapse: A Population Based Cohort Study.

    Védís Helga Eiríksdóttir

    Full Text Available Data on the potential influence of macroeconomic recessions on maternal diseases during pregnancy are scarce. We aimed to assess potential change in prevalence of pregnancy-induced hypertensive disorders (preeclampsia and gestational hypertension during the first years of the major national economic recession in Iceland, which started abruptly in October 2008.Women whose pregnancies resulted in live singleton births in Iceland in 2005-2012 constituted the study population (N = 35,211. Data on pregnancy-induced hypertensive disorders were obtained from the Icelandic Medical Birth Register and use of antihypertensive drugs during pregnancy, including β-blockers and calcium channel blockers, from the Icelandic Medicines Register. With the pre-collapse period as reference, we used logistic regression analysis to assess change in pregnancy-induced hypertensive disorders and use of antihypertensives during the first four years after the economic collapse, adjusting for demographic and pregnancy characteristics, taking aggregate economic indicators into account. Compared with the pre-collapse period, we observed an increased prevalence of gestational hypertension in the first year following the economic collapse (2.4% vs. 3.9%; adjusted odds ratio [aOR] 1.47; 95 percent confidence interval [95%CI] 1.13-1.91 but not in the subsequent years. The association disappeared completely when we adjusted for aggregate unemployment rate (aOR 1.04; 95% CI 0.74-1.47. Similarly, there was an increase in prescription fills of β-blockers in the first year following the collapse (1.9% vs.3.1%; aOR 1.43; 95% CI 1.07-1.90, which disappeared after adjusting for aggregate unemployment rate (aOR 1.05; 95% CI 0.72-1.54. No changes were observed for preeclampsia or use of calcium channel blockers between the pre- and post-collapse periods.Our data suggest a transient increased risk of gestational hypertension and use of β-blockers among pregnant women in Iceland in the

  20. Epidemiology of hypertensive kidney disease.

    Udani, Suneel; Lazich, Ivana; Bakris, George L

    2011-01-01

    The prevalence of hypertension, chronic kidney disease (CKD) and end-stage renal disease (ESRD) attributable to hypertension continues to rise worldwide. Identifying the precise prevalence of CKD attributable to hypertension is difficult owing to the absence of uniform criteria to establish a diagnosis of hypertensive nephropathy. Despite the increasing prevalence of CKD-associated hypertension, awareness of hypertension among individuals with CKD remains suboptimal and rates of blood-pressure control remain poor. Targeted subgroups involved in studies of CKD seem to reach better rates of blood-pressure control, suggesting that this therapeutic goal can be achieved in patients with CKD. Elevated blood-pressure levels are associated with CKD progression. However, the optimal blood-pressure level and pharmacological agent remains unclear. Physicians treating patients with CKD must recognize the importance of maintaining optimal salt and volume balance to achieve blood-pressure goals. Furthermore, agents that modify the renin-angiotensin-aldosterone axis can be an important adjunct to therapy and physicians must monitor expected changes in serum creatinine and electrolyte levels after their administration. Hypertension remains a common factor complicating CKD. Future investigations identifying early signs of hypertension-related CKD, increasing awareness of the effects of hypertension in CKD and determining optimal therapeutic interventions might help reduce the incidence of hypertensive nephropathy.

  1. Dose-response relationship between dietary magnesium intake, serum magnesium concentration and risk of hypertension: a systematic review and meta-analysis of prospective cohort studies.

    Han, Hedong; Fang, Xin; Wei, Xin; Liu, Yuzhou; Jin, Zhicao; Chen, Qi; Fan, Zhongjie; Aaseth, Jan; Hiyoshi, Ayako; He, Jia; Cao, Yang

    2017-05-05

    The findings of prospective cohort studies are inconsistent regarding the association between dietary magnesium intake and serum magnesium concentration and the risk of hypertension. We aimed to review the evidence from prospective cohort studies and perform a dose-response meta-analysis to investigate the relationship between dietary magnesium intake and serum magnesium concentrations and the risk of hypertension. We searched systematically PubMed, EMBASE and the Cochrane Library databases from October 1951 through June 2016. Prospective cohort studies reporting effect estimates with 95% confidence intervals (CIs) for hypertension in more than two categories of dietary magnesium intake and/or serum magnesium concentrations were included. Random-effects models were used to combine the estimated effects. Nine articles (six on dietary magnesium intake, two on serum magnesium concentration and one on both) of ten cohort studies, including 20,119 cases of hypertension and 180,566 participates, were eligible for inclusion in the meta-analysis. We found an inverse association between dietary magnesium intake and the risk of hypertension [relative risk (RR) = 0.92; 95% CI: 0.86, 0.98] comparing the highest intake group with the lowest. A 100 mg/day increment in magnesium intake was associated with a 5% reduction in the risk of hypertension (RR = 0.95; 95% CI: 0.90, 1.00). The association of serum magnesium concentration with the risk of hypertension was marginally significant (RR = 0.91; 95% CI: 0.80, 1.02). Current evidence supports the inverse dose-response relationship between dietary magnesium intake and the risk of hypertension. However, the evidence about the relationship between serum magnesium concentration and hypertension is limited.

  2. Dietary pattern and other lifestyle factors as potential contributors to hypertension prevalence in Arusha City, Tanzania: a population-based descriptive study.

    Katalambula, L K; Meyer, D N; Ngoma, T; Buza, J; Mpolya, E; Mtumwa, A H; Petrucka, P

    2017-08-16

    High blood pressure is increasing worldwide, disproportionately so in developing countries. Inadequate health care systems and adoption of unhealthy lifestyles have been linked to this emergent pattern. To better understand this trend, it is imperative we measure prevalence of hypertension, and examine specific risk factors, at a local level. This study provides a cross-sectional view of urban residents of Arusha City to determine prevalence and associated risk factors. Blood pressure was measured using a digital sphygmomanometer. Interviews were conducted using the WHO STEPwise survey questionnaire to assess lifestyle factors. Dietary intake information was collected by a standardized Food Frequency Questionnaire (FFQ). Descriptive statistics were used to analyze demographic characteristics. Means and standard deviations were calculated for continuous variables and percentages for categorical variables. Pearson's Chi Square (χ 2 ) tests were used to determine significant risk factors for hypertension, and multivariate log binomial regression was used to reveal potential predictors of hypertension. Dietary patterns were analyzed by principal component analysis. Approximately 45% of the study population was found to be hypertensive. The mean arterial blood pressure (MABP) of the sample was 102.3 mmHg (SD = 18.3). Mean systolic and diastolic blood pressure were 136.3 (SD = 30.5) and 85.3 (SD = 16.1) mmHg, respectively. Through multivariate analysis, age and body mass index were found to be independently, positively, associated with hypertension. Adherence to 'healthy' dietary pattern was negatively independently associated with hypertension. With nearly half of participants being hypertensive, this study suggests that hypertension is a significant health risk in Arusha, Tanzania. Obesity, healthy diet, and age were found to be positively associated with hypertension risk. This study did not establish any significant association between increased blood

  3. Dietary pattern and other lifestyle factors as potential contributors to hypertension prevalence in Arusha City, Tanzania: a population-based descriptive study

    L. K. Katalambula

    2017-08-01

    Full Text Available Abstract Background High blood pressure is increasing worldwide, disproportionately so in developing countries. Inadequate health care systems and adoption of unhealthy lifestyles have been linked to this emergent pattern. To better understand this trend, it is imperative we measure prevalence of hypertension, and examine specific risk factors, at a local level. This study provides a cross-sectional view of urban residents of Arusha City to determine prevalence and associated risk factors. Methods Blood pressure was measured using a digital sphygmomanometer. Interviews were conducted using the WHO STEPwise survey questionnaire to assess lifestyle factors. Dietary intake information was collected by a standardized Food Frequency Questionnaire (FFQ. Descriptive statistics were used to analyze demographic characteristics. Means and standard deviations were calculated for continuous variables and percentages for categorical variables. Pearson’s Chi Square (χ 2 tests were used to determine significant risk factors for hypertension, and multivariate log binomial regression was used to reveal potential predictors of hypertension. Dietary patterns were analyzed by principal component analysis. Results Approximately 45% of the study population was found to be hypertensive. The mean arterial blood pressure (MABP of the sample was 102.3 mmHg (SD = 18.3. Mean systolic and diastolic blood pressure were 136.3 (SD = 30.5 and 85.3 (SD = 16.1 mmHg, respectively. Through multivariate analysis, age and body mass index were found to be independently, positively, associated with hypertension. Adherence to ‘healthy’ dietary pattern was negatively independently associated with hypertension. Conclusions With nearly half of participants being hypertensive, this study suggests that hypertension is a significant health risk in Arusha, Tanzania. Obesity, healthy diet, and age were found to be positively associated with hypertension risk. This study did not

  4. Biology of portal hypertension.

    McConnell, Matthew; Iwakiri, Yasuko

    2018-02-01

    Portal hypertension develops as a result of increased intrahepatic vascular resistance often caused by chronic liver disease that leads to structural distortion by fibrosis, microvascular thrombosis, dysfunction of liver sinusoidal endothelial cells (LSECs), and hepatic stellate cell (HSC) activation. While the basic mechanisms of LSEC and HSC dysregulation have been extensively studied, the role of microvascular thrombosis and platelet function in the pathogenesis of portal hypertension remains to be clearly characterized. As a secondary event, portal hypertension results in splanchnic and systemic arterial vasodilation, leading to the development of a hyperdynamic circulatory syndrome and subsequently to clinically devastating complications including gastroesophageal varices and variceal hemorrhage, hepatic encephalopathy from the formation of portosystemic shunts, ascites, and renal failure due to the hepatorenal syndrome. This review article discusses: (1) mechanisms of sinusoidal portal hypertension, focusing on HSC and LSEC biology, pathological angiogenesis, and the role of microvascular thrombosis and platelets, (2) the mesenteric vasculature in portal hypertension, and (3) future directions for vascular biology research in portal hypertension.

  5. Portal Hypertension in Children With Wilms' Tumor: A Report From the National Wilms' Tumor Study Group

    Warwick, Anne B.; Kalapurakal, John A.; Ou, San-San; Green, Daniel M.; Norkool, Pat A.; Peterson, Susan M.; Breslow, Norman E.

    2010-01-01

    Purpose: This analysis was undertaken to determine the cumulative risk of and risk factors for portal hypertension (PHTN) in patients with Wilms' tumor (WT). Methods and Materials: Medical records were reviewed to identify cases of PHTN identified with late liver/spleen/gastric toxicities in a cohort of 5,195 patients treated with National Wilms' Tumor Studies (NWTS) protocols 1 to 4. A nested case control study (5 controls/case) was conducted to determine relationships among doxorubicin, radiation therapy (RT) dose to the liver, patient gender, and PHTN. Conditional logistic regression was used to estimate adjusted hazard ratios (HR) of PHTN associated with these factors. Results: Cumulative risk of PHTN at 6 years from WT diagnosis was 0.7% for patients with right-sided tumors vs. 0.1% for those with left-sided tumors (p = 0.002). Seventeen of 19 cases were evaluable for RT. The majority of cases (16/17 [94%]) received right-flank RT either alone or as part of whole-abdomen RT and received >15 Gy to the liver. Fifteen of 17 (88%) patients received a higher dose to the liver than they would have with modern WT protocols. Controlling for RT dose, the HR was 3.0 for patients who received doxorubicin (p = 0.32) and 2.8 for females (p = 0.15). Controlling for doxorubicin, the 95% lower confidence bound on the HR associating PHTN with a minimum liver RT dose of >15 Gy vs. ≤15 Gy was 2.5 (p = 0.001); it was 2.4 for a maximum liver dose of >15 Gy vs. ≤15 Gy (p = 0.001). Conclusions: There was a strong association between higher doses of liver RT (>15 Gy) and the development of PHTN among WT patients.

  6. Significant interarm blood pressure difference predicts cardiovascular risk in hypertensive patients: CoCoNet study.

    Kim, Su-A; Kim, Jang Young; Park, Jeong Bae

    2016-06-01

    There has been a rising interest in interarm blood pressure difference (IAD), due to its relationship with peripheral arterial disease and its possible relationship with cardiovascular disease. This study aimed to characterize hypertensive patients with a significant IAD in relation to cardiovascular risk. A total of 3699 patients (mean age, 61 ± 11 years) were prospectively enrolled in the study. Blood pressure (BP) was measured simultaneously in both arms 3 times using an automated cuff-oscillometric device. IAD was defined as the absolute difference in averaged BPs between the left and right arm, and an IAD ≥ 10 mm Hg was considered to be significant. The Framingham risk score was used to calculate the 10-year cardiovascular risk. The mean systolic IAD (sIAD) was 4.3 ± 4.1 mm Hg, and 285 (7.7%) patients showed significant sIAD. Patients with significant sIAD showed larger body mass index (P < 0.001), greater systolic BP (P = 0.050), more coronary artery disease (relative risk = 1.356, P = 0.034), and more cerebrovascular disease (relative risk = 1.521, P = 0.072). The mean 10-year cardiovascular risk was 9.3 ± 7.7%. By multiple regression, sIAD was significantly but weakly correlated with the 10-year cardiovascular risk (β = 0.135, P = 0.008). Patients with significant sIAD showed a higher prevalence of coronary artery disease, as well as an increase in 10-year cardiovascular risk. Therefore, accurate measurements of sIAD may serve as a simple and cost-effective tool for predicting cardiovascular risk in clinical settings.

  7. AN EPIDEMIOLOGICAL STUDY OF DIETARY AND EXERCISE HABITS AS CO-RELATES OF HYPERTENSION IN PERSON AGED 45 AND ABOVE IN AGRA DISTRICT

    Renu Agrawal; Mridul Chaturvedi; Sujan Singh; Subhash Chandra Gupta

    2012-01-01

    Background: Due to changing lifestyle in Indian population prevalence of hypertension is increasing which needs modification in dietary and exercise habit of the general population. Objective: A study was designed to correlate dietary and exercise habits with hypertension in general population. Material and methods: Present study is a community based cross sectional study among persons aged more than 45 years in Agra district using PPS multi stage simple random sampling technique with a samp...

  8. Na(+),K(+)-ATPase of human placenta during gestational hypertension: a biochemical-biophysical study

    Rabini, R. A.; Zolese, G.; Staffolani, R.; Lucarelli, G.; Amler, Evžen; Cester, N.; Mazzanti, L.

    1996-01-01

    Roč. 91, č. 6 (1996), s. 719-723 ISSN 0143-5221 Institutional research plan: CEZ:AV0Z5011922 Keywords : activation energy * fluidity * gestational hypertension Subject RIV: CE - Biochemistry Impact factor: 2.154, year: 1996

  9. A Study of 1000 South Mrican Non-White Hypertensive Patients

    1974-04-20

    Apr 20, 1974 ... tension in the Black and Indian patients are discussed. In the Indian ... patient added extra salt to his food in addition to that which had been .... Kalahari Desert has shown that hypertension is less com- mon compared to the ...

  10. The feasible study of vasodilators in portal vein targeting infusion for treating portal hypertension

    Wu Hanping; Liang Huiming; Zheng Chuansheng; Feng Gansheng

    2002-01-01

    Objective: To find out the ideal portal vein tar getting injection routes for portal hypertension treatment. Methods: 28 cirrhotic rat models with portal hypertension induced by CCl 4 were divided into 4 groups: inferior caval vein injection group, portal vein injection group, hepatic artery injection group, spleen injection group. The changes in portal vein pressure (PVP), inferior caval vein pressure (ICVP), mean artery pressure (MAP) and heart rate (HR) were monitored before and after prazosin injection. Results: After intra-portal, intra-hepatic arterial or spleen injection of prazosin, larger decrease in PVP and lesser effects on MAP than intravenous injection had been induced. The effect on HR showed no difference among these four groups. Conclusions: Hepatic artery and spleen prazosin administration have the same advantages on treatment of portal hypertension as those of intra-portal infusion, that is the greater decrease on portal vein pressure, the lesser effects on systemic hemodynamics. Vasodilation drugs for hepatic artery infusion through percutaneous port catheter system by hepatic artery implantation would be an ideal method for portal hypertension treatment

  11. Maternal educational level and risk of gestational hypertension: the Generation R Study.

    L.M. Silva (Lindsay); M. Coolman (Marianne); E.A.P. Steegers (Eric); V.W.V. Jaddoe (Vincent); H.A. Moll (Henriëtte); A. Hofman (Albert); J.P. Mackenbach (Johan); H. Raat (Hein)

    2008-01-01

    textabstractWe examined whether maternal educational level as an indicator of socioeconomic status is associated with gestational hypertension. We also examined the extent to which the effect of education is mediated by maternal substance use (that is smoking, alcohol consumption and illegal drug

  12. Triglyceride and glucose (TyG) index as a predictor of incident hypertension: a 9-year longitudinal population-based study.

    Zheng, Rongjiong; Mao, Yushan

    2017-09-13

    Hypertension and the triglyceride and glucose index both have been associated with insulin resistance; however, the longitudinal association remains unclear. This study was designed to investigate the longitudinal association between the triglyceride and glucose index and incident hypertension among the Chinese population. We studied 4686 subjects (3177 males and 1509 females) and followed up for 9 years. The subjects were divided into four groups based on the triglyceride and glucose index. Univariate and multivariate Cox regression models were used to analyse the risk factors of hypertension. After 9 years of follow-up, 2047 subjects developed hypertension. The overall 9-year cumulative incidence of hypertension was 43.7%, ranging from 28.5% in quartile 1 to 36.9% in quartile 2, 49.2% in quartile 3 and 59.8% in quartile 4 (p for trend triglyceride and glucose index was associated with an increased risk of subsequent incident hypertension. The triglyceride and glucose index can predict the incident hypertension among the Chinese population.

  13. Effects of decompressive cervical surgery on blood pressure in cervical spondylosis patients with hypertension: a time series cohort study.

    Liu, Hong; Wang, Hai-Bo; Wu, Lin; Wang, Shi-Jun; Yang, Ze-Chuan; Ma, Run-Yi; Reilly, Kathleen H; Yan, Xiao-Yan; Ji, Ping; Wu, Yang-feng

    2016-01-06

    Patients with cervical spondylosis myelopathy (CSM) and complicated with hypertension are often experiencing a blood pressure decrease after taking cervical decompressive surgery in clinical observations, but how this blood pressure reduction is associated with the surgery, which cut cervical sympathetic nervous, has never been rigorously assessed. Thus, the purpose of this study is to investigate the effect of cervical decompressive surgery on blood pressure among CSM patients with hypertension. The study will be a time series cohort study. Fifty eligible patients will be selected consecutively from the Peking University First Hospital. Two 24-h ambulatory blood pressure measurement (ABPM) will be taken before the surgery, apart by at least 3 days. The patients will be followed up for another two ABPMs at 1 and 3 months after the surgery. We will recruit subjects with cervical spondylosis myelopathy meeting operation indications and scheduled for receiving cervical decompressive surgery, aged 18-84 years, have a history of hypertension or office systolic blood pressure ≥140 mmHg on initial screening, and willing to participate in the study and provide informed consent. Exclusion criteria includes a history of known secondary hypertension, visual analogue scale (VAS) score ≥4, and unable to comply with study due to severe psychosis. The change in systolic ABPs over the four times will be analyzed to observe the overall pattern of the blood pressure change in relation to the surgery, but the primary analysis will be the comparison of systolic ABP between the 2(nd) and 3(rd), 4(th) measurements (before and after the surgery). We will also calculate the regression-to-the-mean adjusted changes in systolic ABP as sensitivity analysis. Secondary endpoints are the changes in 24 h ABPM diastolic blood pressure, blood pressure control status, the use and dose adjustment of antihypertensive medication, and the incidence of operative complications. Primary outcome

  14. A new risk locus in CHCHD5 for hypertension and obesity in a Chinese child population: a cohort study.

    Wu, Lijun; Gao, Liwang; Zhao, Xiaoyuan; Zhang, Meixian; Wu, Jianxin; Mi, Jie

    2017-09-11

    Coiled-coil-helix-coiled-coil-helix domain containing 5 (CHCHD5), a mitochondrial protein, is involved in the oxidative folding process in the mitochondrial intermembrane space. A previous study identified a hypertension-related single nucleotide polymorphism (SNP), rs3748024, in CHCHD5 in adults, but there are no reports regarding the association between CHCHD5 and obesity, which is a known risk factor for hypertension. The aim of the present study is to investigate the associations of the SNP rs3748024 with hypertension and obesity. Cohort study. Institute of Pediatrics in China. We genotyped the SNP rs3748024 in the Beijing Child and Adolescent Metabolic Syndrome study. A total of 3503 children participated in the study. Genotyping of rs3748024 was conducted using the TaqMan Allelic Discrimination Assay. Lipids and glucose were analysed by an automatic biochemical analyser using a kit assay. The levels of adipocytokines (leptin, adiponectin and resistin) were measured by ELISA techniques. There was a statistically significant association between rs3748024 and systolic blood pressure (SBP) (β=-0.853, 95% CI -1.482 to -0.024, p=0.044) under an additive model adjusted for age, gender and body mass index (BMI) after correction for multiple testing. The SNP was also significantly associated with BMI (β=-0.286, 95% CI -0.551 to -0.021, p=0.043), obesity (OR=0.828, 95% CI 0.723 to 0.949, p=0.018) and triglycerides (β=-0.039, 95% CI -0.070 to -0.007, p=0.044) after correction for multiple testing. We demonstrate for the first time that the SNP rs3748024 in CHCHD5 is associated with SBP, BMI, obesity and triglycerides in Chinese children. Our study identifies a new risk locus for hypertension and obesity in a child population. The function of CHCHD5 remains to be further studied to help elucidate the pathogenic role of CHCHD5 in hypertension and obesity. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights

  15. Sanogenetic effects of exercise on a stationary bike in adolescents with primary arterial hypertension, according to the longitudinal study

    Ye. V. Nedelskaya

    2015-10-01

    Full Text Available The article is devoted to the non-drug treatment of adolescents with arterial hypertension (AH. The aim of our work was to study the effect of exercise on a stationary bike during the training process in teenagers - students of initial courses of ZaporozhyeStateMedicalUniversity. Methods and results. The study was organized on the longitudinal principle using randomized groups of comparison with duration up to 5 years. 82 adolescents (boys - 44, girls - 38 with primary hypertension were selected without target organ affection who has not been systematically involved in sports. This article describes a program of rehabilitation and its impact on the course of hypertension. Positive changes in the blood pressure persist for at least 7 months after ending the exercise course. Thus, we have proved the usefulness of the exercise on a stationary bike in institution. Conclusions. This program has a positive impact on blood pressure directly during the course. Therefore, training courses should continue for a long time

  16. Associations between dietary patterns and self-reported hypertension among Brazilian adults: a cross-sectional population-based study.

    Selem, Soraya Sant'Ana de Castro; Castro, Michelle Alessandra de; César, Chester Luiz Galvão; Marchioni, Dirce Maria Lobo; Fisberg, Regina Mara

    2014-08-01

    Hypertension is a prevalent cardiovascular disease, the important modifiable risk factor of which is diet. The aim of this study was to derive dietary patterns and to test associations with self-reported hypertension and other characteristics, namely demographic, socioeconomic, and lifestyle factors. Data were obtained from the population-based cross-sectional study titled Health Survey of the City of São Paulo, with a random sample of residents of the city of São Paulo, Brazil, aged older than 20 years of both sexes (n=1,102). In 2008, a structured questionnaire with information about socioeconomic, anthropometric, lifestyle, and dietary factors was applied. Dietary intake was estimated by two 24-hour dietary recalls, adjusted by Multiple Source Method. Dietary patterns were obtained through exploratory principal component factor analysis. Poisson regression was used to assess relationships. Three dietary patterns were identified: prudent (fruits, vegetables, whole-grain bread, white cheeses, juices, reduced-fat milk/nonfat milk), traditional (rice, beans, bread/toast/crackers, butter/margarine, whole milk, coffee/teas, sugar), and modern (sodas, pastries/sandwiches/pizzas, yellow cheeses, pastas, sauces, alcoholic beverages, sweets, processed meats). Hypertension and demographic, socioeconomic, and lifestyle factors, as well as the presence of health insurance, were associated with adherence to one or more identified dietary patterns. These results suggest the existence of a target audience for planning and executing public policies of food and nutrition to prevent and control hypertension. Copyright © 2014 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  17. Intra-abdominal fat accumulation is a hypertension risk factor in young adulthood: A cross-sectional study.

    Takeoka, Atsushi; Tayama, Jun; Yamasaki, Hironori; Kobayashi, Masakazu; Ogawa, Sayaka; Saigo, Tatsuo; Kawano, Hiroaki; Abiru, Norio; Hayashida, Masaki; Maeda, Takahiro; Shirabe, Susumu

    2016-11-01

    Accumulation of intra-abdominal fat is related to hypertension. Despite this, a relationship between hypertension and intra-abdominal fat in young adulthood is not clear. In this study, we verify whether intra-abdominal fat accumulation increases a hypertension risk in young adult subjects.In a cross-sectional study, intra-abdominal fat area was measured using a dual bioelectrical impedance analysis instrument in 697 university students (20.3 ± 0.7 years, 425 men). Blood pressure and anthropometric factors were measured. Lifestyle variables including smoking, drinking, physical activity, and eating behavior were assessed with questionnaire. High blood pressure risk (systolic blood pressure ≥130 mm Hg and/or diastolic blood pressure ≥85 mm Hg) with increasing intra-abdominal fat area was evaluated.Participants were divided into 5 groups according to their intra-abdominal fat area (≤24.9, 25-49.9, 50-74.9, 75-99.9, and ≥100 cm). As compared with the values of the smallest intra-abdominal fat area group, the crude and lifestyle-adjusted odds ratios (ORs) were elevated in larger intra-abdominal fat area groups [OR 1.31, 95% confidence interval (CI) 0.66-2.80; OR 3.38, 95% CI 1.60-7.57; OR 7.71, 95% CI 2.75-22.22; OR 18.74, 95% CI 3.93-105.64, respectively). The risk increase was observed only in men.Intra-abdominal fat accumulation is related to high blood pressure in men around 20 years of age. These results indicate the importance of evaluation and reduction of intra-abdominal fat to prevent hypertension.

  18. Patients' Attitudes and Approaches to the Self-Management of Hypertension: Perspectives from an Australian Qualitative Study in Community Pharmacy.

    Bajorek, Beata; Lemay, Kate; Magin, Parker; Roberts, Christopher; Krass, Ines; Armour, Carol

    2017-06-01

    In the management of hypertension, blood pressure (BP) monitoring and medication use are key strategies, but they are dependent on patients' motivation to practice self-care. To gauge patients' approaches to monitoring their blood pressure, as well as explore their attitudes toward, and actions relating to, high blood pressure readings, as the key components of their self-management of hypertension. This qualitative study, comprising individual telephone interviews, involved patients attending community pharmacies in Sydney (Australia). Patients' perspectives were elicited using a purpose-designed, semi-structured interview guide. The verbal responses were audio-recorded, transcribed verbatim, and thematically analysed. Three key themes arose: (1) approaches to monitoring blood pressure, (2) attitudes to variability in BP, (3) responses to high BP readings. Many patients self-regulated the frequency of monitoring based on perceived need and/or opportunity. Most were indifferent toward their readings, regarding BP fluctuations as 'normal'. When a high BP was detected, the action taken was highly variable, with no clear action plans in place. Several patients recognised a high BP to be a consequence of not taking their antihypertensive medication, triggering the resumption of short-term adherence to their preferred management strategy, i.e., self-medication with antihypertensives (i.e., restarting their medication) and/or self-management via lifestyle strategies. This study highlights patients' inappropriate self-management of hypertension. Misperceptions about hypertension, e.g., accepting BP fluctuations as normal, can produce indifferent attitudes as well as influence patients' self-management actions. This lack of insight undermines long-term adherence to antihypertensive therapy.

  19. Hypertensive disorders of pregnancy and risk of diabetes in Indian women: a cross-sectional study.

    Agrawal, Sutapa; Fledderjohann, Jasmine

    2016-08-05

    Epidemiological data from high-income countries suggest that women with hypertensive disorders of pregnancy (HDP) are more likely to develop diabetes later in life. We investigated the association between pre-eclampsia and eclampsia (PE&E) during pregnancy and the risk of diabetes in Indian women. Cross-sectional study. India. Data from India's third National Family Health Survey (NFHS-3, 2005-2006), a cross-sectional survey of women aged 15-49 years, are used. Self-reported symptoms suggestive of PE&E were obtained from 39 657 women who had a live birth in the 5 years preceding the survey. The association between PE&E and self-reported diabetes status was assessed using multivariable logistic regression models adjusting for dietary intake, body mass index (BMI), tobacco smoking, alcohol drinking, frequency of TV watching, sociodemographic characteristics and geographic region. The prevalence of symptoms suggestive of PE&E in women with diabetes was 1.8% (n=207; 95% CI 1.5 to 2.0; pwomen who did not report any PE&E symptoms. In the multivariable analysis, PE&E was associated with 1.6 times (OR=1.59; 95% CI 1.31 to 1.94; pIndian women. These findings are important for a country which is already tackling the burden of young onset of diabetes in the population. However, longitudinal medical histories and a clinical measurement of diabetes are needed in this low-resource setting. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  20. Abnormal pulmonary artery stiffness in pulmonary arterial hypertension: in vivo study with intravascular ultrasound.

    Edmund M T Lau

    Full Text Available BACKGROUND: There is increasing recognition that pulmonary artery stiffness is an important determinant of right ventricular (RV afterload in pulmonary arterial hypertension (PAH. We used intravascular ultrasound (IVUS to evaluate the mechanical properties of the elastic pulmonary arteries (PA in subjects with PAH, and assessed the effects of PAH-specific therapy on indices of arterial stiffness. METHOD: Using IVUS and simultaneous right heart catheterisation, 20 pulmonary segments in 8 PAH subjects and 12 pulmonary segments in 8 controls were studied to determine their compliance, distensibility, elastic modulus and stiffness index β. PAH subjects underwent repeat IVUS examinations after 6-months of bosentan therapy. RESULTS: AT BASELINE, PAH SUBJECTS DEMONSTRATED GREATER STIFFNESS IN ALL MEASURED INDICES COMPARED TO CONTROLS: compliance (1.50±0.11×10(-2 mm(2/mmHg vs 4.49±0.43×10(-2 mm(2/mmHg, p<0.0001, distensibility (0.32±0.03%/mmHg vs 1.18±0.13%/mmHg, p<0.0001, elastic modulus (720±64 mmHg vs 198±19 mmHg, p<0.0001, and stiffness index β (15.0±1.4 vs 11.0±0.7, p = 0.046. Strong inverse exponential associations existed between mean pulmonary artery pressure and compliance (r(2 = 0.82, p<0.0001, and also between mean PAP and distensibility (r(2 = 0.79, p = 0.002. Bosentan therapy, for 6-months, was not associated with any significant changes in all indices of PA stiffness. CONCLUSION: Increased stiffness occurs in the proximal elastic PA in patients with PAH and contributes to the pathogenesis RV failure. Bosentan therapy may not be effective at improving PA stiffness.

  1. Development of Sustained Release "NanoFDC (Fixed Dose Combination" for Hypertension - An Experimental Study.

    Anjuman Arora

    Full Text Available The present study was planned to formulate, characterize and evaluate the pharmacokinetics of a novel "NanoFDC" comprising three commonly prescribed anti-hypertensive drugs, hydrochlorothiazide (a diuretic, candesartan (ARB and amlodipine (a calcium channel blocker.The candidate drugs were loaded in Poly (DL-lactide-co-gycolide (PLGA by emulsion- diffusion-evaporation method. The formulations were evaluated for their size, morphology, drug loading and in vitro release individually. Single dose pharmacokinetic profiles of the nanoformulations alone and in combination, as a NanoFDC, were evaluated in Wistar rats.The candidate drugs encapsulated inside PLGA showed entrapment efficiencies ranging from 30%, 33.5% and 32% for hydrochlorothiazide, candesartan and amlodipine respectively. The nanoparticles ranged in size from 110 to 180 nm. In vitro release profile of the nanoformulation showed 100% release by day 6 in the physiological pH 7.4 set up with PBS (phosphate buffer saline and by day 4-5 in the intestinal pH 1.2 and 8.0 set up SGF (simulated gastric fluid and SIF (simulated intestinal fluid respectively. In pharmacokinetic analysis a sustained-release for 6 days and significant increase in the mean residence time (MRT, as compared to the respective free drugs was noted [MRT of amlodipine, hydrochlorothiazide and candesartan changed from 8.9 to 80.59 hours, 11 to 69.20 hours and 9 to 101.49 hours respectively].We have shown for the first time that encapsulating amlodipine, hydrochlorothiazide and candesartan into a single nanoformulation, to get the "NanoFDC (Fixed Dose Combination" is a feasible strategy which aims to decrease pill burden.

  2. A Mixed-Methods Study to Examine the Role of Psychosocial Stress and Air Pollution on Hypertension in Mexican-Origin Hispanics.

    Rammah, Amal; Walker Whitworth, Kristina; Han, Inkyu; Chan, Wenyaw; Jimenez, Maria D; Strom, Sara S; Bondy, Melissa L; Symanski, Elaine

    2018-04-20

    Independent and combined effects of air pollution and psychosocial stressors on hypertension, a risk factor for cardiovascular disease, among Hispanics are not well studied. We administered a pilot-tested questionnaire on individual- and neighborhood-level psychosocial stressors, developed with community input, to nearly 2500 individuals from the MD Anderson Cancer Center cohort of Mexican-Americans. We used data from local air quality monitors to estimate individual exposures to ozone (O 3 ) and fine particulate matter (PM 2.5 ) for the 12-month period preceding enrollment using inverse distance interpolation. We applied logistic regression models to examine relationships between exposures to psychosocial stressors and air pollution with prevalent hypertension and used stratified analyses to examine the interacting effects of these two exposures on hypertension . RESULTS: There was a positive association between prevalent hypertension and a high frequency of feeling anxious or depressed (prevalence odds ratio (POR) = 1.36, 95% CI [1.06-1.75]) and experiencing aches and pains (POR = 1.29, 95% CI [1.01-1.64]). The odds of having hypertension were also elevated among those worrying about their own health (POR = 1.65, 95% CI [1.30-2.06]) or about not having enough money (POR = 1.27, 95% CI [1.01-1.6]). We observed an inverse association between O 3 and hypertension. There was no interaction between psychosocial stressors and O 3 on hypertension. Our findings add to the evidence of a positive association between individual and family stressors on hypertension among Hispanics and other racial/ethnic groups. Contrary to previous studies reporting positive associations, our results suggest that long-term exposure to O 3 may be inversely related to prevalent hypertension.

  3. Clinical study on the factors affecting the post-partum recovery of patients with hypertensive pregnancy disorders at a Chinese hospital.

    Wei, Jun; Wang, Yan; Xu, Jiayuan; Zhang, Chunfang; Zhou, Helen; Liu, Guoli

    2017-03-01

    The aim of this study was to investigate the post-partum recovery of blood pressure (BP) in women with hypertensive disorders of pregnancy (HDP) and to evaluate HDP risk factors. A total of 124 patients with gestational hypertension (n = 63) or pre-eclampsia (n = 61) who gave birth at Peking University People's Hospital between January and December 2013 were included in this study. The recorded clinical and laboratory parameters included the patients' general information, maternal pre-pregnancy body mass index, gestational weight gain, gestational age at onset and delivery, delivery mode and time taken for BP to return to normal level. Logistic regression analysis was performed to evaluate the influence of various risk factors on post-partum BP recovery. The mean interval for BP normalization was 24.1 ± 22.8 days (median, 7 days). Forty-six percent of the patients recovered from hypertension within three days, and 75% recovered within six weeks of delivery. About 90% of the patients required 60 days for BP to normalize after delivery. After adjusting for confounding factors, post-partum recovery from hypertension was found to be influenced by hypertension severity, maternal serum albumin level, a family history of hypertension and gestational week at delivery. The BP of the majority of the patients with gestational hypertension or pre-eclampsia returned to normal within 60 days of delivery. Hypertension severity, maternal serum albumin level, a family history of family hypertension and gestational week at delivery influenced the time required for BP normalization. © 2016 Japan Society of Obstetrics and Gynecology.

  4. Aldosterone to Active Renin Ratio Is Associated With Nocturnal Blood Pressure in Obese and Treated Hypertensive Patients: The Styrian Hypertension Study

    Grubler, M.R.; Kienreich, K.; Gaksch, M.; Verheyen, N.; Fahrleitner-Pammer, A.; Schmid, J.; Grogorenz, J.; Ablasser, K.; Pieske, B.; Tomaschitz, A.; Pilz, S.

    2014-01-01

    High aldosterone levels are considered to play a key role in arterial hypertension. Data on the relationship between the aldosterone to active renin ratio (AARR), a quantity of aldosterone excess, and ambulatory blood pressure (BP) monitoring (ABPM) during the night are, however, sparse.

  5. Recurrence of hypertensive disorders of pregnancy

    van Oostwaard, Miriam F; Langenveld, Josje; Schuit, Ewoud

    2015-01-01

    OBJECTIVE: We performed an individual participant data (IPD) metaanalysis to calculate the recurrence risk of hypertensive disorders of pregnancy (HDP) and recurrence of individual hypertensive syndromes. STUDY DESIGN: We performed an electronic literature search for cohort studies that reported ...

  6. Renovascular hypertension

    Thomsen, H.S.; Sos, T.A.; Nielsen, S.L.; Koebenhavns Amts Sygehus, Herlev; Cornell Univ., New York

    1989-01-01

    Hypertension constitutes a major health problem and the challenge is to identify patients having 'surgically' curable renal vascular disease among the majority with so-called essential hypertension. The best of unsatisfactory diagnostic tests are renography and plasma renin activity both before and during angiotensin II blockade. The necessity of better screening tests has increased because of the recent advances in surgical techniques and especially percutaneous transluminal renal angioplasty. The latter has definitely become the method of choice for correction of suspected hemodynamically significant artery stenoses whenever technically feasible. With improved angioplasty techniques the risk of treating renal artery stenosis without hemodynamic and clinical importance (so-called cosmetic repair) has increased. Unfortunately randomized trials including surgery versus angioplasty are not available. It should be kept in mind that only after correction of the stenosis is achieved and the blood pressure has become normal, can the diagnosis of renovascular hypertension be made with certainty. (orig.)

  7. Microcirculation and biomarkers in patients with resistant or mild-to-moderate hypertension: a cross-sectional study.

    Junqueira, Camillo L C; Magalhães, Maria Eliane C; Brandão, Andréa Araújo; Ferreira, Esmeralci; Cyrino, Fátima Z G A; Maranhão, Priscila A; Souza, Maria das Graças C; Bottino, Daniel Alexandre; Bouskela, Eliete

    2018-04-23

    Microcirculation influences peripheral vascular resistance and therefore contributes to arterial blood pressure. The aim of this study was to investigate the correlation between serum markers of inflammation and microcirculatory parameters observed by nailfold videocapillaroscopy (NVC) in patients with resistant (RH, 58 [50-63] years, n = 25) or mild-to-moderate hypertension (MMH, 56 [47-64] years, n = 25) compared to normotensive patients (control group (CG), 33 [27-52] years, n = 25). C-reactive protein (CRP), endothelin, adiponectin, I-CAM and V-CAM levels were obtained by laboratory analysis. Functional capillary density (FCD; the number of capillaries with flowing red blood cells by unit tissue area), capillary diameters, maximum red blood cell velocity (RBCV max ) during the reactive hyperemia response/RBCV baseline after 1 min of arterial occlusion at the finger base and time to reach RBCV max were determined by NVC. A sub-analysis was also conducted on hypertensive patients not taking statins, with controlled/uncontrolled blood pressure. The RH group showed lower RBCV and RBCV max values and longer TRBCV max compared to MMH and CG patients, with worse values in those with uncontrolled blood pressure. FCD and diameters showed no significant differences among the three groups, with higher CRP values in the RH and MMH groups. An increase in endothelin was observed only in patients not taking statins in both hypertensive groups. Patients with severe hypertension and uncontrolled blood pressure levels presented more pronounced microvascular dysfunction, as well as higher serum values for CRP and endothelin (without statin treatment), suggesting that the use of statins decreases endothelin release.

  8. Hypertension in the very old; prevalence, awareness, treatment and control: a cross-sectional population-based study in a Spanish municipality

    Aguado, Alba; López, Flora; Miravet, Sonia; Oriol, Pilar; Fuentes, M Isabel; Henares, Belén; Badia, Teresa; Esteve, Lluis; Peligro, Javier

    2009-01-01

    Abstract Background Information on hypertension in the very elderly is sparse. Until recently evidence of benefits from pharmacological treatment was inconclusive. We estimated the prevalence of hypertension in subjects aged 80 or more, the proportion of awareness, treatment and control. Explanatory variables associated with good control were also studied. Methods Cross sectional, population-based study, conducted in Martorell, an urban Spanish municipality, in 2005. By simple random sampling...

  9. Treated Hypertension has No Influence on the Efficacy of Alendronate in the Therapy of Postmenopausal Osteoporosis: A Non-Randomized, Non-Blind, Controlled Prospective Study

    Matziolis, Doerte; Drewke, Monika; Matziolis, Georg; Perka, Carsten

    2011-01-01

    Changes in hormone metabolism during menopause are involved in the development of osteoporosis and arterial hypertension. A mutual influence of these two clinical pictures is evident on the basis of pathophysiological factors. In this study, we investigated whether a drug therapy of hypertension influences the efficacy of a bisphosphonate (alendronate) in the treatment of postmenopausal osteoporosis. For this purpose, 60 female patients were enrolled in the study, 30 of them on drug treatment...

  10. Triglyceride and glucose (TyG) index as a predictor of incident hypertension: a 9-year longitudinal population-based study

    Zheng, Rongjiong; Mao, Yushan

    2017-01-01

    Background Hypertension and the triglyceride and glucose index both have been associated with insulin resistance; however, the longitudinal association remains unclear. This study was designed to investigate the longitudinal association between the triglyceride and glucose index and incident hypertension among the Chinese population. Methods We studied 4686 subjects (3177 males and 1509 females) and followed up for 9?years. The subjects were divided into four groups based on the triglyceride ...

  11. A study of trans-rectal portal scintigraphy for the diagnostic evaluation of portal hypertension with hepatic cirrhosis

    Tang Mingdeng; Dong Weiyu; Liu Yonghua; He Pinyu; Li Zhener

    1996-01-01

    The portal hypertension of hepatic cirrhosis was studied by 99m Tc-MIBI trans-rectum imaging. The portal systemic circulation was evaluated by the heart-liver ratio (H/L ratio) and the portosystemic shunt index (SI). The H/L and SI in 12 normal cases were 0.145 +- 0.042 and 0.124 +- 0.029. Whereas in 18 patients with hepatobiliary diseases of non-cirrhosis were 0.207 +- 0.076 and 0.169 +- 0.051, and in 47 patients with hepatic cirrhosis were 0.751 +-0.313 and 0.422 +- 0.075. The results showed significant difference (P<0.01) between normal controls and non-cirrhosis group, and significant difference (P<0.001) between hepatic cirrhosis group and normal controls, non-cirrhosis group. A significant difference (P<0.05) in child-pugh's classification A, B and C groups was also found. A significant correlation (r = 0.95, P<0.01) with the H/L, SI and portal pressure measurement during operation was found. If H/L≥0.30, and SI≥0.22 were taken as positive criteria for diagnosis of portal hypertension with hepatic cirrhosis, the sensitivity, specificity and accuracy were 96%, 90% and 94% respectively. Therefore, it was a new method for the diagnosis of portal hypertension with hepatic cirrhosis

  12. Effects of Sacubitril/Valsartan Versus Olmesartan on Central Hemodynamics in the Elderly With Systolic Hypertension: The PARAMETER Study.

    Williams, Bryan; Cockcroft, John R; Kario, Kazuomi; Zappe, Dion H; Brunel, Patrick C; Wang, Qian; Guo, Weinong

    2017-03-01

    Effective treatment of systolic hypertension in elderly patients remains a major therapeutic challenge. A multicenter, double-blind, randomized controlled trial with sacubitril/valsartan (LCZ696), a first-in-class angiotensin receptor neprilysin inhibitor, was conducted to determine its effects versus olmesartan (angiotensin receptor blocker) on central aortic pressures, in elderly patients (aged ≥60 years) with systolic hypertension and pulse pressure >60 mm Hg, indicative of arterial stiffness. Patients (n=454; mean age, 67.7 years; mean seated systolic blood pressure, 158.6 mm Hg; mean seated pulse pressure, 69.7 mm Hg) were randomized to receive once-daily sacubitril/valsartan 200 mg or olmesartan 20 mg, force titrated to double the initial doses after 4 weeks, before primary assessment at 12 weeks. The study extended double-blind treatment for 12 to 52 weeks, during which amlodipine (2.5-5 mg) and subsequently hydrochlorothiazide (6.25-25 mg) were added-on for patients not achieving blood pressure target (secondary assessments at week 12 (central aortic pulse pressure, -2.4 mm Hg, P blood pressure and central aortic systolic pressure, -4.1 mm Hg and -3.6 mm Hg, respectively, both P blood pressure parameters were similar between treatments ( P hypertension and stiff arteries. © 2017 American Heart Association, Inc.

  13. Effect of Forest Walking on Autonomic Nervous System Activity in Middle-Aged Hypertensive Individuals: A Pilot Study

    Chorong Song

    2015-03-01

    Full Text Available There has been increasing attention on the therapeutic effects of the forest environment. However, evidence-based research that clarifies the physiological effects of the forest environment on hypertensive individuals is lacking. This study provides scientific evidence suggesting that a brief forest walk affects autonomic nervous system activity in middle-aged hypertensive individuals. Twenty participants (58.0 ± 10.6 years were instructed to walk predetermined courses in forest and urban environments (as control. Course length (17-min walk, walking speed, and energy expenditure were equal between the forest and urban environments to clarify the effects of each environment. Heart rate variability (HRV and heart rate were used to quantify physiological responses. The modified semantic differential method and Profile of Mood States were used to determine psychological responses. The natural logarithm of the high-frequency component of HRV was significantly higher and heart rate was significantly lower when participants walked in the forest than when they walked in the urban environment. The questionnaire results indicated that, compared with the urban environment, walking in the forest increased “comfortable”, “relaxed”, “natural” and “vigorous” feelings and decreased “tension-anxiety,” “depression,” “anxiety-hostility,” “fatigue” and “confusion”. A brief walk in the forest elicited physiological and psychological relaxation effects on middle-aged hypertensive individuals.

  14. Efficacy of Virechana and Basti Karma with Shamana therapy in the management of essential hypertension: A comparative study.

    Shukla, Gyanendra; Bhatted, Santosh K; Dave, Alankruta R; Shukla, Vageesha Datta

    2013-01-01

    Considering high prevalence and the need to look for alternative medicine, essential hypertension was screened in light of Vata-Pitta Pradhana Rakta Pradoshaja Vikara as mentioned by Acharya Charaka. Comparing the etiological factors, symptomatology, and complications with Rakta Pradoshaja Vikara with that of essential hypertension, a striking similarity was revealed. To prove the practical approach of management of Vata-Pitta Pradhana Rakta Pradoshaja Vikara, a randomized open clinical trial on 33 uncomplicated subjects of essential hypertension was conducted. The subjects were allotted in two groups, viz. (Group A) Virechana group having 16 cases who underwent Virechana Karma by Trivrita, Aragvadha, Eranda Taila, and Draksha Kwatha as Sahapana; and (Group B) Basti group consisting of 17 cases who were administered Dashmoola Kala Basti in which Niruha with Dashmoola Kwatha and Anuvasana with Dashmoola Taila was done. Patients of both the groups were followed by Shamana Chikitsa (Arjunadi Ghanavati). The overall effect of the therapies on systolic and diastolic blood pressure showed that Virechana proved better relief (43.75%) as compared to Basti (29.41%). The response was encouraging and has created scope for further studies.

  15. RV Fractional Area Change and TAPSE as Predictors of Severe Right Ventricular Dysfunction in Pulmonary Hypertension: A CMR Study.

    Hoette, Susana; Creuzé, Nicolas; Günther, Sven; Montani, David; Savale, Laurent; Jaïs, Xavier; Parent, Florence; Sitbon, Olivier; Rochitte, Carlos Eduardo; Simonneau, Gerald; Humbert, Marc; Souza, Rogerio; Chemla, Denis

    2018-04-01

    The right ventricular ejection fraction (RVEF) is a surrogate marker of right ventricular function in pulmonary hypertension (PH), but its measurement is complicated and time consuming. The tricuspid annular plane systolic excursion (TAPSE) measures only the longitudinal component of RV contraction while the right ventricular fractional area change (RVFAC) takes into account both the longitudinal and the transversal components. The aim of our study was to evaluate the relationship between RVEF, RVFAC, and TAPSE according to hemodynamic severity in two groups of patients with PH: pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH). Fifty-four patients with PAH (n = 15) and CTEPH (n = 39) underwent right heart catheterization and cardiac magnetic resonance (CMR). The ventricular volumes and areas, TAPSE, and eccentricity index were measured. The RVFAC was more strongly correlated with the RVEF (r = 0.81, p good index to estimate RVEF in PH patients; even better than the TAPSE in patients with more severe hemodynamic profile, possibly for including the transversal component of right ventricular function in its measurement. Furthermore, RVFAC performance was similar in the two PH groups (PAH and CTEPH).

  16. Exercise Hypertension.

    Schultz, Martin G; Sharman, James E

    2014-05-01

    Irrespective of apparent 'normal' resting blood pressure (BP), some individuals may experience an excessive elevation in BP with exercise (i.e. systolic BP ≥210 mm Hg in men or ≥190 mm Hg in women or diastolic BP ≥110 mm Hg in men or women), a condition termed exercise hypertension or a 'hypertensive response to exercise' (HRE). An HRE is a relatively common condition that is identified during standard exercise stress testing; however, due to a lack of information with respect to the clinical ramifications of an HRE, little value is usually placed on such a finding. In this review, we discuss both the clinical importance and underlying physiological contributors of exercise hypertension. Indeed, an HRE is associated with an increased propensity for target organ damage and also predicts the future development of hypertension, cardiovascular events and mortality, independent of resting BP. Moreover, recent work has highlighted that some of the elevated cardiovascular risks associated with an HRE may be related to high-normal resting BP (pre-hypertension) or ambulatory 'masked' hypertension and that an HRE may be an early warning signal of abnormal BP control that is otherwise undetected with clinic BP. Whilst an HRE may be amenable to treatment via pharmacological and lifestyle interventions, the exact physiological mechanism of an HRE remains elusive, but it is likely a manifestation of multiple factors including large artery stiffness, increased peripheral resistance, neural circulatory control and metabolic irregularity. Future research focus may be directed towards determining threshold values to denote the increased risk associated with an HRE and further resolution of the underlying physiological factors involved in the pathogenesis of an HRE.

  17. Pre-Hypertension and Hypertension in Adolescence: How much ...

    Background: Hypertension is an important worldwide public-health challenge because of its high frequency and concomitant risks of cardiovascular and kidney disease. Previous studies have documented that hypertension may begin in adolescence, perhaps even in childhood. Objectives: This study set out to determine ...

  18. Lifelong physical activity in maintaining bone strength in older men and women of the Age, Gene/Environment Susceptibility-Reykjavik Study.

    Rianon, N J; Lang, T F; Sigurdsson, G; Eiriksdottir, G; Sigurdsson, S; Garcia, M; Pajala, S; Koster, A; Yu, B; Selwyn, B J; Taylor, W C; Kapadia, A S; Gudnason, V; Launer, L J; Harris, T B

    2012-09-01

    We examined if lifelong physical activity is important for maintaining bone strength in the elderly. Associations of quantitative computerized tomography-acquired bone measures (vertebral and femoral) and self-reported physical activity in mid-life (mean age, 50 years), in old age (≥65 years), and throughout life (recalled during old age) were investigated in 2,110 men and 2,682 women in the AGES-Reykjavik Study. Results conclude lifelong physical activity with continuation into old age (≥65 years) best maintains better bone health later in life. Skeletal loading is thought to modulate the loss of bone in later life, and physical activity is a chief means of affecting bone strength by skeletal loading. Despite much discussion regarding lifelong versus early adulthood physical activity for preventing bone loss later in life, inconsistency still exists regarding how to maintain bone mass later in life (≥65 years). We examined if lifelong physical activity is important for maintaining bone strength in the elderly. The associations of quantitative computerized tomography-acquired vertebral and femoral bone measures and self-reported physical activity in mid-life (mean age, 50 years), in old age (≥65 years), and throughout life (recalled during old age) were investigated in 2,110 men and 2,682 women in the AGES-Reykjavik Study. Our findings conclude that lifelong physical activity with continuation into old age (≥65 years) best maintains better bone health in the elderly.

  19. Association of bariatric surgery with risk of acute care use for hypertension-related disease in obese adults: population-based self-controlled case series study.

    Shimada, Yuichi J; Tsugawa, Yusuke; Iso, Hiroyasu; Brown, David F M; Hasegawa, Kohei

    2017-08-23

    Hypertension carries a large societal burden. Obesity is known as a risk factor for hypertension. However, little is known as to whether weight loss interventions reduce the risk of hypertension-related adverse events, such as acute care use (emergency department [ED] visit and/or unplanned hospitalization). We used bariatric surgery as an instrument for investigating the effect of large weight reduction on the risk of acute care use for hypertension-related disease in obese adults with hypertension. We performed a self-controlled case series study of obese patients with hypertension who underwent bariatric surgery using population-based ED and inpatient databases that recorded every bariatric surgery, ED visit, and hospitalization in three states (California, Florida, and Nebraska) from 2005 to 2011. The primary outcome was acute care use for hypertension-related disease. We used conditional logistic regression to compare each patient's risk of the outcome event during sequential 12-month periods, using pre-surgery months 13-24 as the reference period. We identified 980 obese patients with hypertension who underwent bariatric surgery. The median age was 48 years (interquartile range, 40-56 years), 74% were female, and 55% were non-Hispanic white. During the reference period, 17.8% (95% confidence interval [CI], 15.4-20.2%) had a primary outcome event. The risk remained unchanged in the subsequent 12-month pre-surgery period (18.2% [95% CI, 15.7-20.6%]; adjusted odds ratio [aOR] 1.02 [95% CI, 0.83-1.27]; P = 0.83). In the first 12-month period after bariatric surgery, the risk significantly decreased (10.5% [8.6-12.4%]; aOR 0.58 [95% CI, 0.45-0.74]; P bariatric surgery (12.9% [95% CI, 10.8-15.0%]; aOR 0.71 [95% CI, 0.57-0.90]; P = 0.005). By contrast, there was no significant reduction in the risk among obese patients who underwent non-bariatric surgery (i.e., cholecystectomy, hysterectomy, spinal fusion, or mastectomy). In this population-based study of

  20. Noise Exposure and Risk of Hypertension: A Cross-Sectional Study

    Seyed Javad Haji-Miresmaeil

    2008-11-01

    Full Text Available Background:Previous studies have indicated an unspecific correlation between noise exposure and blood pressure disturbances. Blood pressure disturbances could be caused by the environmental hazards such as noise exposure.The aim of this study is to analyze whether there is a relationship between noise exposure and hypertension.Methods: Atotal sample of 218 workers working in a small workshop aged between 27 and 49 yrs answered the questionnaire in this survey. Blood pressure was measured in the sitting position after 5 minutes rest. Level of sound intensity in the workplace was measured by sound level meter (SKC Model CEL-480-440 and human noise exposure level was measured by audiometric device (MEVOX. The correlation between industrial noise and blood pressure was extracted. The t-test and Fisher’s exact test was used to compare   the qualitative variables and quantitative variables with normal distribution as being applied in parametric tests. Odds ratio (OR with 95% confidence interval (95% CI was used to compare the magnitude of risk variables.Results: Sub-populations in this study consisted of 109 workers with noise exposure more than 85 dB (Case group and the rest (i.e. 109 workers with noise exposure less than 85 dB (Control group. High level systolic and diastolic blood pressure was more prevalent in the case group. Total hearing loss more than 25dB was significantly more prevalent in the case group (45% of case group have hearing loss. Adjusted Odds Ratio (OR for the effect of age, food type and BMI on blood pressure was 3.56 (95% CI: 6.6 – 1.9. Conclusion: This study showed that high blood pressure (>_140/90 mmHg was more prevalent in the case group. This finding persisted after adjustment was made for age, food   type, and BMI. (Odds Ratio 3.56 (95% CI: 6.6 – 1.9.  

  1. Hypertensive target organ damage in Ghanaian civil servants with hypertension.

    Juliet Addo

    2009-08-01

    Full Text Available Low levels of detection, treatment and control of hypertension have repeatedly been reported from sub Saharan Africa, potentially increasing the likelihood of target organ damage.A cross-sectional study was conducted on 1015 urban civil servants aged > or = 25 years from seven central government ministries in Accra, Ghana. Participants diagnosed to have hypertension were examined for target organ involvement. Hypertensive target organ damage was defined as the detection of any of the following: left ventricular hypertrophy diagnosed by electrocardiogram, reduction in glomerular filtration rate, the presence of hypertensive retinopathy or a history of a stroke.Of the 219 hypertensive participants examined, 104 (47.5% had evidence of target organ damage. The presence of target organ damage was associated with higher systolic and diastolic blood pressure levels. The odds of developing hypertensive target organ damage was five to six times higher in participants with blood pressure (BP > or = 180/110 mmHg compared to those with BP < 140/90 mmHg, and there was a trend to higher odds of target organ damage with increasing BP (p = 0.001. Women had about lower odds of developing target organ damage compared to men.The high prevalence of target organ damage in this working population associated with increasing blood pressure, emphasises the need for hypertension control programs aimed at improving the detection of hypertension, and importantly addressing the issues inhibiting the effective treatment and control of people with hypertension in the population.

  2. Vascular inflammatory cells in hypertension

    David G. Harrison

    2012-05-01

    Full Text Available Hypertension is a common disorder with uncertain etiology. In the last several years, it has become evident that components of both the innate and adaptive immune system play an essential role in hypertension. Macrophages and T cells accumulate in the perivascular fat, the heart and the kidney of hypertensive patients and in animals with experimental hypertension. Various immunosuppressive agents lower blood pressure and prevent end-organ damage. Mice lacking lymphocytes are protected against hypertension, and adoptive transfer of T cells, but not B cells in the animals restores their blood pressure response to stimuli such as angiotensin II or high salt. Recent studies have shown that mice lacking macrophages have blunted hypertension in response to angiotensin II and that genetic deletion of macrophages markedly reduces experimental hypertension. Dendritic cells have also been implicated in this disease. Many hypertensive stimuli have triggering effects on the central nervous system and signals arising from the circumventricular organ seem to promote inflammation. Studies have suggested that central signals activate macrophages and T cells, which home to the kidney and vasculature and release cytokines, including IL-6 and IL-17, which in turn cause renal and vascular dysfunction and lead to blood pressure elevation. These recent discoveries provide a new understanding of hypertension and provide novel therapeutic opportunities for treatment of this serious disease.

  3. Neighbourhood walkability and incidence of hypertension: Findings from the study of 429,334 UK Biobank participants.

    Sarkar, Chinmoy; Webster, Chris; Gallacher, John

    2018-04-01

    With an estimated one billion hypertension cases worldwide, the role of the built environment in its prevention and control is still uncertain. The present study aims to examine the associations between neighbourhood walkability and hypertension in a large and diverse population-based cohort. We examined the association between neighbourhood walkability and blood pressure outcomes for N = 429,334 participants drawn from the UK Biobank and aged 38-73 years. Neighbourhood walkability was objectively modelled from detailed building footprint-level data within multi-scale functional neighbourhoods (1.0-, 1.5- and 2.0-kilometer street catchments of geocoded dwelling). A series of linear and modified Poisson regression models were employed to examine the association between walkability and outcomes of diastolic blood pressure (DBP in mmHg), systolic blood pressure (SBP in mmHg) and prevalent hypertension adjusting for socio-demographic, lifestyle and related physical environmental covariates. We also examined the relationship between walkability and change in blood pressure for a sub-sample of participants with follow-up data and tested for interaction effects of age, sex, employment status, neighbourhood SES, residential density and green exposure. Neighbourhood walkability within one-kilometer street catchment was beneficially associated with all the three blood pressure outcomes, independent of all other factors. Each interquartile increment in walkability was associated with the lower blood pressure outcomes of DBP (β = -0.358, 95% CI: -0.42, -0.29 mmHg), SBP (β = -0.833, 95% CI: -0.95, -0.72 mmHg) as well as reduced hypertension risk (RR = 0.970, 95% CI: 0.96, 0.98). The results remained consistent across spatial and temporal scales and were sensitive to sub-groups, with pronounced protective effects among female participants, those aged between 50 and 60 years, in employment, residing in deprived, high density and greener areas. This large

  4. Hypertension Health Promotion via Text Messaging at a Community Health Center in South Africa: A Mixed Methods Study.

    Hacking, Damian; Haricharan, Hanne J; Brittain, Kirsty; Lau, Yan Kwan; Cassidy, Tali; Heap, Marion

    2016-03-10

    The use of mobile phones to deliver health care (mHealth) is increasing in popularity due to the high prevalence of mobile phone penetration. This is seen in developing countries, where mHealth may be particularly useful in overcoming traditional access barriers. Non-communicable diseases may be particularly amenable to mHealth interventions, and hypertension is one with an escalating burden in the developing world. The objective of this study was to test whether the dissemination of health information via a short message service (SMS) led to improvements in health knowledge and self-reported health-related behaviors. A mixed methods study was carried out among a cohort of 223 hypertension clinic patients, in a resource-poor setting in Cape Town, South Africa, in 2012. Hypertensive outpatients were recruited at the clinic and administered a baseline questionnaire to establish existing knowledge of hypertension. Participants were then randomly assigned to intervention or control groups. The intervention group received 90 SMSes over a period of 17 weeks. Thereafter, the baseline questionnaire was readministered to both groups to gauge if any improvements in health knowledge had occurred. Those who received SMSes were asked additional questions about health-related behavior changes. A focus group was then conducted to obtain in-depth feedback about participants' experience with, and response to, the SMS campaign. No statistically significant changes in overall health knowledge were observed between the control and intervention groups. The intervention group had positive increases in self-reported behavior changes. These were reaffirmed by the focus groups, which also revealed a strong preference for the SMS campaign and the belief that the SMSes acted as a reminder to change, as opposed to providing new information. Although the content of the SMSes was not new, and did not improve health knowledge, SMSes were effective in motivating positive self-reported behavior

  5. [Ultrasonographic study of blood flow in the renal arteries of patients with arterial hypertension].

    Makarenko, E S; Dombrovskiĭ, V I; Nelasov, N Iu

    2012-01-01

    Vascular duplex ultrasound duplex with simultaneous ECG registration was made to estimate the quantitative and time parameters of blood flow in the renal arteries with grade 1-2 arterial hypertension. There were increases in vascular resistance indices and acceleration phase index and a reduction in systolic phase index. There were correlations of the time parameters of blood flow in the renal arteries with age and lipidogram values.

  6. Central arteriovenous anastomosis for the treatment of patients with uncontrolled hypertension (the ROX CONTROL HTN study): a randomised controlled trial.

    Lobo, Melvin D

    2015-01-22

    Hypertension contributes to cardiovascular morbidity and mortality. We assessed the safety and efficacy of a central iliac arteriovenous anastomosis to alter the mechanical arterial properties and reduce blood pressure in patients with uncontrolled hypertension.

  7. Social participation and the onset of hypertension among the middle-aged and older population: Evidence from the China Health and Retirement Longitudinal Study.

    Tu, Raoping; Inoue, Yosuke; Yazawa, Aki; Hao, Xiaoning; Cai, Guoxi; Li, Yueping; Lin, Xiuquan; He, Fei; Yamamoto, Taro

    2018-03-30

    While previous studies have examined the association between health-related behaviors and hypertension, comparatively little attention has been paid to the role of social participation (i.e. participating in community organizations). The aim of the present study was to investigate the longitudinal association between social participation and hypertension among the middle-aged and older population (aged ≥45 years) in China where the prevalence of hypertension has been increasing rapidly in the past few decades. Data came from the China Health and Retirement Longitudinal Study waves 2011 and 2013. Information was obtained from 5483 participants on blood pressure, social participation and covariates. A sex-stratified Poisson regression model with a robust variance estimator was used to examine the associations. During the period between 2011 and 2013, 20.6% of men and 17.2% of women developed hypertension. A Poisson regression model showed that participating in community organizations once a week or more frequently was inversely associated with the onset of hypertension in women (incidence rate ratio 0.80, 95% confidence interval 0.67-0.95, P = 0.012). Among men, no such association was found. The present study suggests that promoting social participation might help mitigate the disease burden associated with hypertension in China, particularly among women. Geriatr Gerontol Int 2018; ••: ••-••. © 2018 Japan Geriatrics Society.

  8. Poor blood pressure control and its associated factors among older people with hypertension: A cross-sectional study in six public primary care clinics in Malaysia

    Cheong Ai Theng

    2015-07-01

    Full Text Available Hypertension is highly prevalent in the older people. Chronic disease care is a major burden in the public primary care clinics in Malaysia. Good blood pressure (BP control is needed to reduce the morbidity and mortality of cardiovascular disease (CVD. This study aimed to determine the status of BP control and its associated factors among older people with hypertension in public primary care clinics.

  9. Food Groups and Risk of Hypertension: A Systematic Review and Dose-Response Meta-Analysis of Prospective Studies.

    Schwingshackl, Lukas; Schwedhelm, Carolina; Hoffmann, Georg; Knüppel, Sven; Iqbal, Khalid; Andriolo, Violetta; Bechthold, Angela; Schlesinger, Sabrina; Boeing, Heiner

    2017-11-01

    The aim of this systematic review and meta-analysis was to summarize the evidence on the relation of the intakes of 12 major food groups, including whole grains, refined grains, vegetables, fruits, nuts, legumes, eggs, dairy, fish, red meat, processed meat, and sugar-sweetened beverages (SSBs) with the risk of hypertension. PubMed, Scopus, and Web of Science were searched systematically until June 2017 for prospective studies having quantitatively investigated the above-mentioned foods. We conducted meta-analysis on the highest compared with the lowest intake categories and linear and nonlinear dose-response meta-analyses to analyze the association. Summary RRs and 95% CIs were estimated by using a random-effects model. Overall, 28 reports were included in the meta-analysis. An inverse association for the risk of hypertension was observed for 30 g whole grains/d (RR: 0.92; 95% CI: 0.87, 0.98), 100 g fruits/d (RR: 0.97; 95% CI: 0.96, 0.99), 28 g nuts/d (RR: 0.70; 95% CI: 0.45, 1.08), and 200 g dairy/d (RR: 0.95; 95% CI: 0.94, 0.97), whereas a positive association for 100 g red meat/d (RR: 1.14; 95% CI: 1.02, 1.28), 50 g processed meat/d (RR: 1.12; 95% CI: 1.00, 1.26), and 250 mL SSB/d (RR: 1.07; 95% CI: 1.04, 1.10) was seen in the linear dose-response meta-analysis. Indication for nonlinear relations of the intakes of whole grains, fruits, fish, and processed meats with the risk of hypertension was detected. In summary, this comprehensive dose-response meta-analysis of 28 reports identified optimal intakes of whole grains, fruits, nuts, legumes, dairy, red and processed meats, and SSBs related to the risk of hypertension. These findings need to be seen under the light of very-low to low quality of meta-evidence. However, the findings support the current dietary guidelines in the prevention of hypertension. © 2017 American Society for Nutrition.

  10. Unexpected finding of a high prevalence of perinatal hypertension in a rural Haitian village: An observational study

    Bryce C Gagliano

    2016-01-01

    Full Text Available Background Hypertensive disorders in pregnancy are associated with maternal mortality worldwide. In Haiti, the risk of perinatal maternal death is high with sparse data concerning the prevalence of gestational hypertension (HTN reported from remote regions. Maternal morbidity associated with HTN-related sequellae will place a strain on the family unit. Thus, it is vital to the health of mothers as well as the rural communities to gain a better understanding of HTN with the goal of decreasing perinatal morbidity and mortality in areas without access to advanced healthcare. Methods In this study, we measured the prevalence of HTN in perinatal women in the Thomazeau region of Haiti who presented to a regional clinic staffed by volunteer international providers. Retrospective pre- and postpartum data was analyzed from 436 women who presented between January 2013 and July 2015. Additionally, a subset of current (June-July 2015 prepartum (n=200 and postpartum (n=82 women had a urinalysis performed to access for proteinuria and other urine markers. Demographic data collected included blood pressure, age, weight, height, gravidity, and parity. The criteria for HTN was defined as two blood pressure readings taken at separate time points with systolic and diastolic pressures greater than 140 and 90 mmHg, respectively. Results In this cohort of 436 women, 57 (13.1% met the criteria of HTN before giving birth and 98 (22.5% afterwards. Of the women found to be hypertensive, 64 (65.3% of the hypertensive women after birth had not been hypertensive prepartum. Within the two-week current period assessing 282 women, 3 (1.5% prepartum and 13 (15.9% postpartum women with HTN had trace proteinuria. Conclusions In this cohort of rural women, we describe an unusually high prevalence of new onset postpartum HTN. As complications of gestational HTN including preeclampsia and eclampsia may contribute to perinatal morbidity and mortality for both mother and baby in

  11. 3A.05: HYPERTENSION AND RISK OF EVENTS ASSOCIATED TO REDUCED EGFR. THE ESCARVAL-RISK STUDY.

    Tellez-Plaza, M; Orozco-Beltran, D; Gil-Guillen, V; Navarro-Pérez, J; Pallares, V; Valls, F; Fernandez, A; Martin-Moreno, J M; Sanchis, C; Dominguez-Lucas, A; Redon, J

    2015-06-01

    The objective of the present study was to evaluate the potential impact of hypertension in the increased CVD risk associated with CKD in a population with at least one main CV risk factor (CVRF), hypertension, dyslipidemia or diabetes.(Figure is included in full-text article.) : 54,620 men and women aged 30 years or older with at least one of main CVRF (hypertension, diabetes mellitus and/or dyslipidemia), who attended for routine health maintenance have been selected. Patients with a history of a previous CVD event were excluded. At the time of inclusion information about CVRF and their active treatments as well as smoking habit and biochemistry lab values were collected from the EHR. Estimated glomerular filtration rate (eGFR) was calculated using the CKD-EPI. Participants were followed-up for the first episode of hospitalization for myocardial infarction or stroke and all cause of death were collected. Interaction terms for dichotomous eGFR (>=60, dislipidemia 86%, diabetes in 35.5% and obesity in 41,8%. A total of 7884 (14.4%) patients had eGFR below 60 ml/min/1.73 m2 and among them 1807 (3.3%) 45 ml/min/1.73 m2 or lower. During a time follow-up of 3.2 years, patients years exposure, 960 death were recorded. A significant increment in the risk for total mortality was observed in subjects with eGFR 45 ml/min/1.73 m2 or below adjusted for multiple potential confounders (HR 1.83, 1.28-2.62; CI 95th). In normotensive subjects the risk did not increase below 60 ml/min/1.73 m2 in contrast with the increment in hypertensives. (Figure 1 on the previous page). eGFR is a prevalent condition in patients with the main CV risk factors. eGFR below <45 ml/min/1.73 m2 increases mortality risk. Hypertension by itself had an important role in the risk of mortality in patients with low eGFR on top of other CV risk factors.

  12. Essential hypertension vs. secondary hypertension among children.

    Gupta-Malhotra, Monesha; Banker, Ashish; Shete, Sanjay; Hashmi, Syed Sharukh; Tyson, John E; Barratt, Michelle S; Hecht, Jacqueline T; Milewicz, Diane M; Boerwinkle, Eric

    2015-01-01

    The aim was to determine the proportions and correlates of essential hypertension among children in a tertiary pediatric hypertension clinic. We evaluated 423 consecutive children and collected demographic and clinical history by retrospective chart review. We identified 275 (65%) hypertensive children (blood pressure >95th percentile per the "Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents") from 423 children referred to the clinic for history of elevated blood pressure. The remainder of the patients had normotension (11%), white coat hypertension (11%), prehypertension (10%), and pending diagnosis (3%). Among the 275 hypertensive children, 43% (n = 119; boys = 56%; median age = 12 years; range = 3-17 years) had essential hypertension and 57% (n = 156; boys = 66%; median age = 9 years; range = 0.08-19 years) had secondary hypertension. When compared with those with secondary hypertension, those with essential hypertension had a significantly older age at diagnosis (P = 0.0002), stronger family history of hypertension (94% vs. 68%; P secondary hypertension. The phenotype of essential hypertension can present as early as 3 years of age and is the predominant form of hypertension in children after age of 6 years. Among children with hypertension, those with essential hypertension present at an older age, have a stronger family history of hypertension, and have lower prevalence of preterm birth. © American Journal of Hypertension, Ltd 2014. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  13. A STUDY ON HYPERTENSION AND IT’S DETERMINANTS AMONG MALE BUS DRIVERS IN STATE ROAD TRANSPORT CORPORATION, VISAKHAPATNAM, ANDHRA PRADESH

    Bhaskara Rao

    2015-10-01

    Full Text Available INTRODUCTION: Hypertension is an iceberg disease and it remains silent, being generally asymptomatic most of its course. It is one of the major risk factors for cardiovascular mortality, which accounts for 20 - 50% of all deaths. The nature of profession puts bus drivers at higher risk of developing hypertension. Due to lack of information regarding the prevalence of hypertension and its determinants among the RTC bus drivers in Visakhapatnam, the present study is carried out. OBJECTIVE : To measure occurrence of certain ri sk factors for hypertension among bus drivers and to study the proportion of bus drivers having hypertension METHODOLOGY: A cross sectional descriptive study was conducted among bus drivers working in APSRTC Visakhapatnam city during months of Dec . 2014 – Jan . 2 015. One of the six bus depots was randomly selected, a prior permission from the depot manager was taken and convenient sample of 100 bus drivers considered for study. Data was collected using a pre tested semi structured questionnaire to the study subject s after obtaining informed consent. All the individuals who are willing to participate were included and those not willing to participate and who were60years of age were excluded from the study. Data was analyzed by using Microsoft excel, sta tistical tests were applied where ever necessary and p value of <0.05 was considered as statistical significant. Study materials include mercury sphygmomanometer, stethoscope, measuring tape, weighing machine. RESULTS: The mean age of study population was 42.9years, majority (90% of them belongs to class II and III according to modified B. G. Prasad’s classification, prevalence of hypertension among study population was (36%, of whom 44.4% of participants were not aware of their hypertensive status. Famil y history of hypertension observed in 46% of the study population. About 59% of the study population were overweight & obese, of them 45.7% had hypertension

  14. Dietary habits of hypertensive patients in a tertiary hypertension ...

    Introduction: The prescriptions regarding non-pharmacological care in the management of hypertension has been carefully defined by the various practice guidelines. However, there is paucity of data on dietary practices in our environment, therefore this study set out to determine the dietary practices of hypertensive ...

  15. Murine study of portal hypertension associated endothelin-1 hypo-response.

    Theodorakis, Nicholas; Maluccio, Mary; Skill, Nicholas

    2015-04-28

    To investigate endothelin-1 hypo-responsive associated with portal hypertension in order to improve patient treatment outcomes. Wild type, eNOS(-/-) and iNOS(-/-) mice received partial portal vein ligation surgery to induce portal hypertension or sham surgery. Development of portal hypertension was determined by measuring the splenic pulp pressure, abdominal aortic flow and portal systemic shunting. To measure splenic pulp pressure, a microtip pressure transducer was inserted into the spleen pulp. Abdominal aortic flow was measured by placing an ultrasonic Doppler flow probe around the abdominal aorta between the diaphragm and celiac artery. Portal systemic shunting was calculated by injection of fluorescent microspheres in to the splenic vein and determining the percentage accumulation of spheres in liver and pulmonary beds. Endothelin-1 hypo-response was evaluated by measuring the change in abdominal aortic flow in response to endothelin-1 intravenous administration. In addition, thoracic aorta endothelin-1 contraction was measured in 5 mm isolated thoracic aorta rings ex-vivo using an ADI small vessel myograph. In wild type and iNOS(-/-) mice splenic pulp pressure increased from 7.5 ± 1.1 mmHg and 7.2 ± 1 mmHg to 25.4 ± 3.1 mmHg and 22 ± 4 mmHg respectively. In eNOS(-/-) mice splenic pulp pressure was increased after 1 d (P = NS), after which it decreased and by 7 d was not significantly elevated when compared to 7 d sham operated controls (6.9 ± 0.6 mmHg and 7.3 ± 0.8 mmHg respectively, P = 0.3). Abdominal aortic flow was increased by 80% and 73% in 7 d portal vein ligated wild type and iNOS when compared to shams, whereas there was no significant difference in 7 d portal vein ligated eNOS(-/-) mice when compared to shams. Endothelin-1 induced a rapid reduction in abdominal aortic blood flow in wild type, eNOS(-/-) and iNOS(-/-) sham mice (50% ± 8%, 73% ± 9% and 47% ± 9% respectively). Following portal vein ligation endothelin-1 reduction in blood flow

  16. Nonalcoholic Fatty Liver Disease and Associated Metabolic Risks of Hypertension in Type 2 Diabetes: A Cross-Sectional Community-Based Study

    Xiaoying Ding

    2017-01-01

    Full Text Available The mechanisms facilitating hypertension in diabetes still remain to be elucidated. Nonalcoholic fatty liver disease (NAFLD, which is a higher risk factor for insulin resistance, shares many predisposing factors with diabetes. However, little work has been performed on the pathogenesis of hypertension in type 2 diabetes (T2DM with NAFLD. The aim of this study is to investigate the prevalence of hypertension in different glycemic statuses and to analyze relationships between NAFLD, metabolic risks, and hypertension within a large community-based population after informed written consent. A total of 9473 subjects aged over 45 years, including 1648 patients with T2DM, were enrolled in this cross-sectional study. Clinical and biochemical parameters of all participants were determined. The results suggested that the patients with prediabetes or T2DM were with higher risks to have hypertension. T2DM with NAFLD had significantly higher levels of blood pressure, triglyceride, uric acid, and HOMA-IR than those without NAFLD. Data analyses suggested that hypertriglyceridemia [OR = 1.773 (1.396, 2.251], NAFLD [OR = 2.344 (1.736, 3.165], hyperuricemia [OR = 1.474 (1.079, 2.012], and insulin resistance [OR = 1.948 (1.540, 2.465] were associated with the higher prevalence of hypertension independent of other metabolic risk factors in type 2 diabetes. Further studies are needed to focus on these associations.

  17. Prospective Cohort Study to Elucidate the Correlation between Occupational Stress and Hypertension Risk in Oil Workers from Kelamayi City in the Xinjiang Uygur Autonomous Region of China.

    Li, Rong; Gao, Xiaoyan; Liu, Bo; Ge, Hua; Ning, Li; Zhao, Junling; Liu, Jiwen

    2016-12-22

    The purpose of this study was to assess the major risk factors for hypertension in oil workers, and investigate the effect of occupational stress on the incidence of hypertension after controlling for other risk factors. A prospective cohort approach was used following enrollment of 1354 oil workers. The occupational stress experienced by oil workers was higher than for the general population in China. By the end of the cohort study, 231 new cases of hypertension among the oil workers had been diagnosed. The cumulative incidence of hypertension was 17.06%. There were 44, 112, and 75 workers who developed hypertension in the low, intermediate, and high occupational stress groups, which represented a 12.0%, 15.6%, and 20.3% cumulative incidence, respectively (chi-square value = 9.812, p occupational stress group was 1.549 (1.072-2.236) compared to the low exposure group, and 2.337 (1.191-4.585) in female subjects. Our study indicated that an increase in occupational stress was associated with an increased risk of hypertension after other factors were adjusted.

  18. Effect of angiotensin converting enzyme inhibition after acute myocardial infarction in patients with arterial hypertension. TRACE Study Group, Trandolapril Cardiac Event

    Gustafsson, F; Torp-Pedersen, C; Køber, L

    1997-01-01

    patients who entered the study, 400 (23%) had a history of arterial hypertension. The mean follow-up time was 26 months. MAIN OUTCOME MEASURES: Mortality from any cause. Secondary endpoints were sudden death, cardiovascular mortality, reinfarction and development of severe heart failure. RESULTS......OBJECTIVE: To evaluate the influence of a history of arterial hypertension on the efficacy of the angiotensin converting enzyme (ACE) inhibitor trandolapril in patients with acute myocardial infarction (AMI) and left ventricular dysfunction. METHODS: A retrospective analysis of data from......: Of the patients in the hypertensive group, 173 (43%) died during follow-up, versus 500 (37%) in the normotensive group. Treatment with trandolapril resulted in a relative risk of death from any cause for the hypertensive group of 0.59 (96% confidence interval 0.44-0.80), versus 0.85 (0.72-1.02) for normotensive...

  19. [Clinical and experimental studies on the pathogenesis in pregnancy induced hypertension].

    Hidaka, A

    1988-08-01

    Placental ischemia is one of the etiological factors of pregnancy induced hypertension (PIH), however, the pathogenesis of placental and renal ischemia has not been clarified. The purposes of this investigation are (1) to clarify the fetomaternal hemodynamic changes in PIH and the influence of maternal postural change on fetomaternal hemodynamics, measured by thermodilution method, impedance cardiography and pulsed doppler method during pregnancy, (2) to provide to relationship between intrauterine resting tonus and maternal hemodynamics, that is, blood pressure, placental and renal blood flow measured by electromagnetic flowmeter and thermocouple method, and renal nerve activity, and (3) to study the influence of placental ischemia on vascular sensitivity to angiotensin II measured by Magnus method in animal experiment. (1) The increase in C.O and blood volume were recognized from the beginning of pregnancy to 24 GW, and subsequently, the decreasing tendency were found from about 32 GW to the onset of labor. However this decreasing tendency were subsided in the lateral position. These circulatory changes were observed in both normotensive and PIH cases, and especially, the decrease in C.O and blood volume in late pregnancy were more remarkable in PIH than that in normotensive pregnancy. From the results of Starling curve, left ventricular work was more hyperdynamic status in PIH than that in normotensive pregnancy, these results show that there are a compensatory mechanism against high vascular resistance in PIH. A/B (S/D) ratio in uterine artery, umbilical artery and fetal aorta were lowered in II-nd and III-rd trimester and more decreased in the lateral position from the supine position, on the other hand these ratio in PIH were elevated respectively. These results show that there are the aortocaval compression by the heavy tensive uterus and subsequent sluice flow mechanism in fetoplacental circulation in the supine position in late pregnancy. (2) These

  20. [Clinical study of hemostatic coagulation markers in prethrombosis state of pregnancy induced hypertension].

    Shi, Qing; Chen, Chen; Wang, Xue-Feng; Wang, Hong-Li

    2004-11-01

    To investigate the relationship between the hemostatic coagulation markers of prethrombosis state and pregnancy induced hypertension (PIH). Forty-five PIH patients and 20 control patients were studied. P-selectin, prothrombin fragments 1 + 2 (F1+2), D-dimers (D-D) and plasmin-antiplasmin complex (PAP) were measured by enzyme linked immunosorbent assay. Antithrombin activity (AT: A) was measured by chromogenic peptide substrate assay. (1) The P-selectin level of pre-delivery in moderate and severe PIH patients was (66 +/- 24) microg/L and (80 +/- 30) microg/L, it was (49 +/- 15) microg/L in the control group (both P post partum in severe PIH group and control group was (65 +/- 34) microg/L and (40 +/- 12) microg/L, with significant difference between them (P < 0.05). (2) The F1+2 level of pre-delivery in mild, moderate and severe PIH groups was respectively (2.2 +/- 0.2), (2.3 +/- 0.4) and (2.2 +/- 0.2) nmol/L, being all significantly higher than that in the control group, which was (1.2 +/- 0.3) nmol/L, but there was no obvious difference between three PIH groups. (3) The D-D level in mild, moderate and severe PIH groups was respectively (0.7 +/- 0.1), (0.7 +/- 0.3) and (0.8 +/- 0.2) mg/L, and it was (0.4 +/- 0.1) mg/L in the control group. The D-D level was increased when PIH became severe. (4) The PAP level in moderate and severe PIH groups was (0.8 +/- 0.4) mg/L and (0.8 +/- 0.4) mg/L, being significantly higher than that in control group (0.7 +/- 0.3) mg/L (both P < 0.05). (5) The AT: Aactivity was obviously decreased in PIH groups, being respectively (44 +/- 37)%, (64 +/- 25)% and (83 +/- 39)% in severe, moderate and mild PIH groups. There was obvious difference between severe and mild groups (P < 0.01). Elevated P-selectin levels and increased platelet activity were observed in PIH patients. F1+2 may be useful as a screening test for risk pregnancy. D-D can be used as an early monitor of DIC. AT: A reflects the severity of illness. These molecular markers may

  1. Does the aldosterone: renin ratio predict the efficacy of spironolactone over bendroflumethiazide in hypertension? A clinical trial protocol for RENALDO (RENin-ALDOsterone study

    McInnes Gordon T

    2007-05-01

    Full Text Available Abstract Background High blood pressure is an important determinant of cardiovascular disease risk. Treated hypertensives do not attain a risk level equivalent to normotensives. This may be a consequence of suboptimal blood pressure control to which indiscriminate use of antihypertensive drugs may contribute. Indeed the recent ALLHAT1study suggests that thiazides should be given first to virtually all hypertensives. Whether this is correct or whether different antihypertensive therapies should be targeted towards different patients is a major unresolved issue, which we address in this study. The measurement of the ratio of aldosterone: renin is used to identify hypertensive subjects who may respond well to treatment with the aldosterone antagonist spironolactone. It is not known if subjects with a high ratio have aldosteronism or aldosterone-sensitive hypertension is debated but it is important to know whether spironolactone is superior to other diuretics such as bendroflumethiazide in this setting. Methods/design The study is a double-blind, randomised, crossover, controlled trial that will randomise 120 hypertensive subjects to 12 weeks treatment with spironolactone 50 mg once daily and 12 weeks treatment with bendroflumethiazide 2.5 mg once daily. The 2 treatment periods are separated by a 2-week washout period. Randomisation is stratified by aldosterone: renin ratio to include equal numbers of subjects with high and low aldosterone: renin ratios. Primary Objective – To test the hypothesis that the aldosterone: renin ratio predicts the antihypertensive response to spironolactone, specifically that the effect of spironolactone 50 mg is greater than that of bendroflumethiazide 2.5 mg in hypertensive subjects with high aldosterone: renin ratios. Secondary Objectives – To determine whether bendroflumethiazide induces adverse metabolic abnormalities, especially in subjects with high aldosterone: renin ratios and if baseline renin measurement

  2. Study of palmar dermatoglyphics in patients with essential hypertension between the age group of 20-50 years

    Rudragouda S Bulagouda, Purnima J Patil, Gavishiddppa A Hadimani, Balappa M Bannur, Patil BG, Nagaraj S. Mallashetty, Ishwar B Bagoji

    2013-10-01

    Full Text Available Background: In present study, we tried to determine significant palmar dermatoglyphic parameters in case of essential hypertensive’s in age group between 20-50 years and whether the parameters can be used for screening purpose i.e., early detection of hypertension. Method: With the use of modified Purvis Smith method, Black duplicating ink (Kores, Bombay was smeared on both hands one by one and prints will be taken by rolling the hands from wrist creases to finger tips on the roller covered with bond paper. While crystal bond paper, applied firmly over a wooden pad, was used for recording the inked epidermal ridge patterns. Rolled finger prints were recorded after applying uniform pressure on white bond paper from ulnar to radial side. Complete palm impression, including the hollow or the palm was obtained over paper. Thus one set of finger prints and palm prints was obtained. The prints obtained were immediately examined with hand-lens. Result: Right hand and left hand of the both male and female study group showed more number of arches than controls. Right hand and left hand of the both male and female study group showed more number of Radial loops than controls. The right hand and left hand of both male and female control group showed more number of ulnar loops than study group. The right hand and left hand of the male control group showed more number of Whorls than study, while in females, the right hand study group showed more number of whorls than control group and the left hand study group showed less number of Whorls as compared to control group. Conclusion: The present study indicates that there are some genetic factors which are involved in the causation of essential hypertension and it is possible to certain extent to predict from dermatoglyphics individual’s chance of acquiring essential hypertension. Like clinical history, examination and investigations, the dermatoglyphics will play an important role revealing the genetic

  3. Primary hypertension among a population of Nigerian secondary school adolescents: Prevalence and correlation with anthropometric indices: A cross-sectional study.

    Uwaezuoke, S N; Okoli, C V; Ubesie, A C; Ikefuna, A N

    2016-01-01

    To assess the prevalence of primary hypertension and its correlation with anthropometric indices among a population of Nigerian adolescents. A cross-sectional study of secondary school adolescents aged 10-19 years in Enugu, Nigeria, using multi-staged sampling method. Anthropometry and blood pressures were measured using standardized instruments. Data analysis was with the Statistical Package for Social Sciences (SPSS) Version 20.0 (Chicago, IL, USA). A total of 2419 adolescents (mean age, 14.80 ± 2.07 years) were included in the study. Prevalence of hypertension was 10.7%. Systolic and diastolic hypertension were observed in 232 (9.6%) and 85 (3.5%) of the participants, respectively. Forty-two of the 137 obese (30.7%) compared to 158 among the 1777 (7.7%) with normal body mass index (BMI) (P hypertension. Waist circumference (r = 0.37) and BMI (r = 0.37) significantly and positively correlated with systolic hypertension. Obese and overweight adolescents had higher prevalence of primary hypertension than their counterparts with normal BMI.

  4. Prevalence and Gender-Specific Influencing Factors of Hypertension among Chinese Adults: A Cross-Sectional Survey Study in Nanchang, China

    Hui Zhou

    2018-02-01

    Full Text Available Hypertension has become the leading cause of death worldwide; data on hypertension among Nanchang adults are sparse. The aim of this study was to investigate the prevalence and gender-specific influencing factors of hypertension in adults in Nanchang, China. A cross-sectional survey was conducted with a representative sample of 2722 Chinese residents aged 18 years and above between May and September 2016, with a response rate of 92.4% (2516/2722. A stratified cluster sampling method was adopted in this study. Data on prevalence and influencing factors were obtained from a standard questionnaire and physical measurements. Univariate and multivariate logistic regressions were performed to analyze the influencing factors. The age-standardized prevalence was 19.8% (18.2–21.3 (male: 19.5% (18.0–21.1; female, 20.01% (18.5–21.6. Factors positively associated with hypertension prevalence were past smoking, diabetes mellitus (DM, and overweight and obesity in both genders. Abdominal obesity and family history of cardiovascular diseases (CVD were risk factors only in males; sleeping time and consumption of fresh vegetables and fruits were related to the prevalence of hypertension only in females. These findings will form the baseline information for the development of more effective approaches to enhance current prevention and control management of hypertension.

  5. Study population and treatment titration in the International Nifedipine GITS Study: Intervention as a Goal in Hypertension Treatment (INSIGHT).

    Brown, M J; Castaigne, A; de Leeuw, P W; Mancia, G; Rosenthal, T; Ruilope, L M

    1998-12-01

    To ascertain the baseline characteristics of the high-risk hypertensive patients entering the International Nifedipine GITS Study: Intervention as a Goal in Hypertension Treatment (INSIGHT). To determine the success of single and combination therapy in achieving target blood pressures in such a population. INSIGHT is a double-blind, prospective outcome trial comparing the efficacy of the calcium channel blocker, nifedipine GITS, and the thiazide, co-amilozide, in preventing myocardial infarction and stroke. We recruited 2996 men and 3454 women, aged 55-80 years, with blood pressure during placebo run-in >150/95 mmHg or isolated systolic blood pressure >160 mmHg from nine countries. Treatment allocation to nifedipine GITS 30 mg daily or co-amilozide (hydrochlorothiazide 25 mg/amiloride 5 mg) once daily was performed by minimization rather than randomization to balance additional risk factors. This was followed by four optional increases in treatment: dose-doubling of the primary drug, addition of atenolol 25/50 mg or enalapril 5/10 mg, and then any other hypotensive drug excluding calcium blockers or diuretics. Target blood pressure was 140/90 mmHg or a fall > or = 20/10 mmHg. Blood pressure at randomization was 172+/-15 / 99+/-9 mmHg. Thirteen per cent of the patients were previously untreated. The proportions of each additional risk factors were: smoking > 10/day, 29%; cholesterol > 6.43 mmol/l, 52%; family history of premature myocardial infarction or stroke, 21%; diabetes mellitus 20%; left ventricular hypertrophy, 10%; previous myocardial infarction, other presentations of coronary heart disease, and peripheral vascular disease, each 6%; proteinuria, 3%. Fifty-five per cent of patients had one additional risk factor, whereas 33%, 9% and 3% had two, three or more additional risk factors, respectively. The blood pressure (and falls in blood pressure) at the end of titration and at 1 year after minimization was 139+/-12 / 82+/-7 mmHg (33+/-15 / 17+/-9) in the 5226

  6. Management of diabetic hypertensives

    Ganesh, Jai; Viswanathan, Vijay

    2011-01-01

    Hypertension occurs twice as commonly in diabetics than in comparable nondiabetics. Patients with both disorders have a markedly higher risk for premature microvascular and macrovascular complications. Aggressive control of blood pressure (BP) reduces both micro- and macrovascular complications. In diabetic hypertensives, angiotensin converting enzyme inhibitors (ACEIs) are the first line in management of hypertension, and can be replaced by angiotensin II receptor blockers (ARBs) if patients are intolerant of them. Recent studies suggest ARBs to be on par with ACEI in reducing both macro- and microvascular risks. Adding both these agents may have a beneficial effect on proteinuria, but no extra macrovascular risk reduction. Thiazides can also be used as first line drugs, but are better used along with ACEI/ARBs. Beta-blockers [especially if the patient has coronary artery disease] and calcium channel blockers are used as second line add-on drugs. Multidrug regimens are commonly needed in diabetic hypertensives. Achieving the target BP of <130/80 is the priority rather than the drug combination used in order to arrest and prevent the progression of macro- and microvascular complications in diabetic hypertensives. PMID:22145142

  7. Culturally adaptive storytelling method to improve hypertension control in Vietnam - "We talk about our hypertension": study protocol for a feasibility cluster-randomized controlled trial.

    Allison, Jeroan J; Nguyen, Hoa L; Ha, Duc A; Chiriboga, Germán; Ly, Ha N; Tran, Hanh T; Phan, Ngoc T; Vu, Nguyen C; Kim, Minjin; Goldberg, Robert J

    2016-01-14

    Vietnam is experiencing an epidemiologic transition with an increased prevalence of non-communicable diseases. At present, the major risk factors for cardiovascular disease (CVD) are either on the rise or at alarming levels in Vietnam; inasmuch, the burden of CVD will continue to increase in this country unless effective prevention and control measures are put in place. A national survey in 2008 found that the prevalence of hypertension (HTN) was approximately 25 % among Vietnamese adults and it increased with advancing age. Therefore, novel, large-scale, and sustainable interventions for public health education to promote engagement in the process of detecting and treating HTN in Vietnam are urgently needed. A feasibility randomized trial will be conducted in Hung Yen province, Vietnam to evaluate the feasibility and acceptability of a novel community-based intervention using the "storytelling" method to enhance the control of HTN in adults residing in four rural communities. The intervention will center on stories about living with HTN, with patients speaking in their own words. The stories will be obtained from particularly eloquent patients, or "video stars," identified during Story Development Groups. The study will involve two phases: (i) developing a HTN intervention using the storytelling method, which is designed to empower patients to facilitate changes in their lifestyle practices, and (ii) conducting a feasibility cluster-randomized trial to investigate the feasibility, acceptability, and potential efficacy of the intervention compared with usual care in HTN control among rural residents. The trial will be conducted at four communes, and within each commune, 25 individuals 50 years or older with HTN will be enrolled in the trial resulting in a total sample size of 100 patients. This feasibility trial will provide the necessary groundwork for a subsequent large-scale, fully powered, cluster-randomized controlled trial to test the efficacy of our novel

  8. PP092. Satisfaction and experiences of pregnant hypertensive women participating in a feasibility study of guided imagery effects on blood pressure.

    Moffatt, F Wight; Hodnett, E; Esplen, M J; Watt-Watson, J

    2012-07-01

    Hypertensive disorders of pregnancy are associated with maternal and perinatal health risk. Some studies have demonstrated blood pressure reduction from the use of relaxation therapies, although previous study in pregnancy was limited. We undertook a RCT to determine the effects of guided imagery relaxation on BP and anxiety in hypertensive women during pregnancy, to answer feasibility questions for a larger trial. This presentation will describe experiences and satisfaction with study participation, as reported by women in our study. Pregnant women with hypertension (n=69) were randomized to two daily periods of guided imagery or quiet rest, for 4weeks or until delivery, whichever came first. Participants provided compliance data and evaluated guided imagery each week, and completed postpartum questionnaires about their satisfaction with study participation. Sixty women completed at least one week in the study. Compliance with allocated group conditions was high. Most women were satisfied with their allocation; 83.3% would choose to be in the study again. A greater proportion (42.4%) indicated that the study reassured them, compared to 3.4% who felt it added to their worry. Of those in the Guided Imagery group providing ratings, more than 75% reported enjoyment and ease of use. Most indicated they would use it for future hypertension in pregnancy and for stress, and would recommend it to others. Our results suggest that Guided Imagery may moderate BP increases in pregnant women with hypertension. However, success of any clinical intervention requires a high degree of patient compliance and acceptability. Guided imagery was acceptable, based on reported use and intent to use it for future stress and hypertension. Guided imagery can be used by hypertensive pregnant women to promote relaxation. Further research is required to determine whether it can improve physical and psychological health outcomes during pregnancy, birthing and postpartum. Copyright © 2012

  9. Patient and healthcare provider barriers to hypertension awareness, treatment and follow up: a systematic review and meta-analysis of qualitative and quantitative studies.

    Rasha Khatib

    Full Text Available BACKGROUND: Although the importance of detecting, treating, and controlling hypertension has been recognized for decades, the majority of patients with hypertension remain uncontrolled. The path from evidence to practice contains many potential barriers, but their role has not been reviewed systematically. This review aimed to synthesize and identify important barriers to hypertension control as reported by patients and healthcare providers. METHODS: Electronic databases MEDLINE, EMBASE and Global Health were searched systematically up to February 2013. Two reviewers independently selected eligible studies. Two reviewers categorized barriers based on a theoretical framework of behavior change. The theoretical framework suggests that a change in behavior requires a strong commitment to change [intention], the necessary skills and abilities to adopt the behavior [capability], and an absence of health system and support constraints. FINDINGS: Twenty-five qualitative studies and 44 quantitative studies met the inclusion criteria. In qualitative studies, health system barriers were most commonly discussed in studies of patients and health care providers. Quantitative studies identified disagreement with clinical recommendations as the most common barrier among health care providers. Quantitative studies of patients yielded different results: lack of knowledge was the most common barrier to hypertension awareness. Stress, anxiety and depression were most commonly reported as barriers that hindered or delayed adoption of a healthier lifestyle. In terms of hypertension treatment adherence, patients mostly reported forgetting to take their medication. Finally, priority setting barriers were most commonly reported by patients in terms of following up with their health care providers. CONCLUSIONS: This review identified a wide range of barriers facing patients and health care providers pursuing hypertension control, indicating the need for targeted multi

  10. Role of Adding Spironolactone and Renal Denervation in True Resistant Hypertension: One-Year Outcomes of Randomized PRAGUE-15 Study.

    Rosa, Ján; Widimský, Petr; Waldauf, Petr; Lambert, Lukáš; Zelinka, Tomáš; Táborský, Miloš; Branny, Marian; Toušek, Petr; Petrák, Ondřej; Čurila, Karol; Bednář, František; Holaj, Robert; Štrauch, Branislav; Václavík, Jan; Nykl, Igor; Krátká, Zuzana; Kociánová, Eva; Jiravský, Otakar; Rappová, Gabriela; Indra, Tomáš; Widimský, Jiří

    2016-02-01

    This randomized, multicenter study compared the relative efficacy of renal denervation (RDN) versus pharmacotherapy alone in patients with true resistant hypertension and assessed the effect of spironolactone addition. We present here the 12-month data. A total of 106 patients with true resistant hypertension were enrolled in this study: 52 patients were randomized to RDN and 54 patients to the spironolactone addition, with baseline systolic blood pressure of 159±17 and 155±17 mm Hg and average number of drugs 5.1 and 5.4, respectively. Twelve-month results are available in 101 patients. The intention-to-treat analysis found a comparable mean 24-hour systolic blood pressure decline of 6.4 mm Hg, P=0.001 in RDN versus 8.2 mm Hg, P=0.002 in the pharmacotherapy group. Per-protocol analysis revealed a significant difference of 24-hour systolic blood pressure decline between complete RDN (6.3 mm Hg, P=0.004) and the subgroup where spironolactone was added, and this continued within the 12 months (15 mm Hg, P= 0.003). Renal artery computed tomography angiograms before and after 1 year post-RDN did not reveal any relevant changes. This study shows that over a period of 12 months, RDN is safe, with no serious side effects and no major changes in the renal arteries. RDN in the settings of true resistant hypertension with confirmed compliance is not superior to intensified pharmacological treatment. Spironolactone addition (if tolerated) seems to be more effective in blood pressure reduction. © 2015 American Heart Association, Inc.

  11. Effects of nebivolol and atenolol on central aortic pressure in hypertensive patients: a multicenter, randomized, double-blind study.

    Redón, Josep; Pascual-Izuel, Jose M; Rodilla, Enrique; Vicente, Antonio; Oliván, Josefina; Bonet, Josep; Torguet, Josep Pere; Calaforra, Oscar; Almirall, Jaume

    2014-06-01

    The main objective was to compare the mean change in augmentation index of hypertensive patients treated with nebivolol or atenolol. Multicenter, double-blind randomized study conducted in six Spanish centers. We enrolled outpatients between the ages of 40 and 65 years with mild or moderate essential hypertension (systolic blood pressure, SBP ≥ 140 mmHg to ≤ 179 mmHg and diastolic blood pressure, DBP ≥ 90 mmHg to ≤ 109 mmHg after a 2-week run-in placebo period). Patients received nebivolol 5 mg or atenolol 50 mg once daily. At week 3, atenolol could be titrated up to 100 mg qd for non-responders. Additionally, patients not achieving normal blood pressure after 6 weeks could be treated with 25 mg hydrochlorothiazide. Follow-up visits were at 3, 6 and 10 weeks. The final study population of 138 patients (58% men; median age 52.6 years, range 40-67 years) was randomized into two groups of 69 patients each. Baseline characteristics of the two groups were similar. At the screening visit, 69% presented with mild hypertension. Nebivolol modified the mean augmentation index to a lesser extent than atenolol after 10 weeks (mean difference 3.1%, 95% CI 0.55-5.69; p = 0.027). A higher proportion of patients in the atenolol group required a diuretic. Reductions in central aortic pressure and peripheral arterial pressure were similar for both treatment groups. The study confirms that nebivolol produces a less pronounced impact on augmentation index than atenolol.

  12. Associations between